1033111877 NPI number — THE BRANDE SAAD GROUP

Table of content: (NPI 1033111877)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033111877 NPI number — THE BRANDE SAAD GROUP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE BRANDE SAAD GROUP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033111877
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/28/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1213 13TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALTOONA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16601-3433
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-944-4011
Provider Business Mailing Address Fax Number:
814-944-5805

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1213 13TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALTOONA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16601-3433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-944-4011
Provider Business Practice Location Address Fax Number:
814-944-5805
Provider Enumeration Date:
08/11/2005

Additional Information

Authorized Official

Authorized Official Last Name:
EDWARDS
Authorized Official First Name:
MICHELLE
Authorized Official Middle Name:
K
Authorized Official Title or Position:
BILLING MANAGER
Authorized Official Telephone Number:
814-944-4011

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  OEG002016 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: OE004298 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: OEG000688 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 09958 . This is a "SPECTERA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3461 . This is a "DAVIS VISION" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 110393 . This is a "EYEMED VISION CARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1361043 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0009332 . This is a "DORAL DR. JULIA MILANAK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 396411 . This is a "NVA DR. WILLIAM SAAD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0009330 . This is a "DORAL DR. WILLIAM SAAD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 396409 . This is a "NVA DR. JULIA MILANAK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: PA04298 . This is a "VBA DR. WILLIAM SAAD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: PA06984 . This is a "VBA DR. JULIA MILANAK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1522724 . This is a "GATEWAY MEDICAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 322250 . This is a "UPMC DR. JULIA MILANAK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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