MEDICARE: BRANDON ALONSO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	37AC00951600	NJ
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1801693957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDON ALONSO

Provider Business Mailing Address
First Line	:	274 MADISON AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-0701
Country	:	US
Telephone Number	:	212-203-1773
Fax Number	:	646-665-4427

Provider Business Practice Location Address
First Line	:	274 MADISON AVE RM 1501
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-0701
Country	:	US
Telephone Number	:	212-203-1773
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2025
Last Update Date	:	06/06/2026

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Directions to “ BRANDON ALONSO ” Practice Location

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