Healthcare Provider Details

I. General information

NPI: 1750174009
Provider Name (Legal Business Name): DR MICHAEL BRANDON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 MERCHANTS WAY
COLTS NECK NJ
07722-1553
US

IV. Provider business mailing address

8 MERCHANTS WAY
COLTS NECK NJ
07722-1553
US

V. Phone/Fax

Practice location:
  • Phone: 848-301-1515
  • Fax:
Mailing address:
  • Phone: 848-301-1515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL BRANDON
Title or Position: DOCTOR
Credential: DC
Phone: 848-301-1515