1578710695 NPI number — MICHAEL M. BRAND, M.D.,P.A.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578710695 NPI number — MICHAEL M. BRAND, M.D.,P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MICHAEL M. BRAND, M.D.,P.A.
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:
1578710695
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/03/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5 FRANKLIN AVE.
Provider Second Line Business Mailing Address:
SUITE 307
Provider Business Mailing Address City Name:
BELLEVILLE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07109
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-751-5644
Provider Business Mailing Address Fax Number:
973-751-5678

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5 FRANKLIN AVE.
Provider Second Line Business Practice Location Address:
SUITE 307
Provider Business Practice Location Address City Name:
BELLEVILLE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-751-5644
Provider Business Practice Location Address Fax Number:
973-751-5678
Provider Enumeration Date:
08/20/2008

Additional Information

Authorized Official

Authorized Official Last Name:
BRAND
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
973-751-5644

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X , with the licence number:  MA22361 , 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)

  • Identifier: 2738201 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com