Healthcare Provider Details

I. General information

NPI: 1609054352
Provider Name (Legal Business Name): JANET BRANDT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2008
Last Update Date: 06/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

69 TOWNSEND CT
FRANKLIN PARK NJ
08823-1522
US

IV. Provider business mailing address

4 LILY CT
YORKTOWN HEIGHTS NY
10598-2533
US

V. Phone/Fax

Practice location:
  • Phone: 914-302-7531
  • Fax:
Mailing address:
  • Phone: 914-302-7531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number473801
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF332787
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00375400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: