Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | MT208381 | PA |
NPI | 1023403573 |
---|---|
Provider Name | Dr. Joshua Daniel Brandstadter |
First Address | Philadelphia, PA 19104-4238 |
Second Address | Philadelphia, PA 19104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2015 |
Last Update Date | 17/03/2018 |