1871776260 NPI number — DR. DINAH JOAN BRAUDE KREMBERG PHD

Table of content: DR. DINAH JOAN BRAUDE KREMBERG PHD (NPI 1871776260)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871776260 NPI number — DR. DINAH JOAN BRAUDE KREMBERG PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BRAUDE KREMBERG
Provider First Name:
DINAH
Provider Middle Name:
JOAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BRAUDE
Provider Other First Name:
DINAH
Provider Other Middle Name:
JOAN
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1871776260
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/10/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1215 BRIAR WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FT LEE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07024
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1215 BRIAR WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FT LEE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-224-8405
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  35S100207400 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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