Provider Demographics
NPI:1366576449
Name:ZEV BRANDEL MD,PC
Entity type:Organization
Organization Name:ZEV BRANDEL MD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZEV
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANDEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-868-3080
Mailing Address - Street 1:2504 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-3538
Mailing Address - Country:US
Mailing Address - Phone:516-868-3080
Mailing Address - Fax:516-771-6851
Practice Address - Street 1:2504 GRAND AVE
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-3538
Practice Address - Country:US
Practice Address - Phone:516-868-3080
Practice Address - Fax:516-771-6851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2070191207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5998709OtherGHI
NY00V18WR861Medicare PIN
NY5998709OtherGHI
NYG55123Medicare UPIN