Healthcare Provider Details

I. General information

NPI: 1184606329
Provider Name (Legal Business Name): LORI M BRAND-ABEND MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2005
Last Update Date: 01/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 OLCOTT SQ
BERNARDSVILLE NJ
07924-2326
US

IV. Provider business mailing address

35 OLCOTT SQ
BERNARDSVILLE NJ
07924-2326
US

V. Phone/Fax

Practice location:
  • Phone: 908-766-2730
  • Fax:
Mailing address:
  • Phone: 908-766-2730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number25MA05300500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number25MA05300500
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number25MA05300500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: