Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 58101 | MA |
N | 111NI0900X | Internist | 58101 | MA |
Y | 207RG0300X | Geriatric Medicine | 166195 | NY |
N | 207RG0300X | Geriatric Medicine | 58101 | MA |
NPI | 1023093994 |
---|---|
Provider Name | Gabriel H Brandeis |
First Address | New York, NY 11373 |
Second Address | New York, NY 11373 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2005 |
Last Update Date | 06/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110049558A | (05) | MA |
BG3A | (05) | NY |
E74365 | (02) | MA |