Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 21779 | NY |
Y | 213ES0000X | Sports Medicine | 21779 | NY |
NPI | 1114210150 |
---|---|
Provider Name | Julie Michelle Brandwein |
First Address | Brooklyn, NY 11225-4114 |
Second Address | Brooklyn, NY 11225-4114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2011 |
Last Update Date | 24/05/2011 |