Healthcare Provider Details

I. General information

NPI: 1902172265
Provider Name (Legal Business Name): MEREDITH BRANDON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2012
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 MAIN ST
PATERSON NJ
07503-3028
US

IV. Provider business mailing address

645 MAIN ST
PATERSON NJ
07503-3028
US

V. Phone/Fax

Practice location:
  • Phone: 973-754-2805
  • Fax: 973-754-4688
Mailing address:
  • Phone: 973-754-2805
  • Fax: 973-754-4688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number25MA09928200
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25MA09928200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: