Healthcare Provider Details

I. General information

NPI: 1376601203
Provider Name (Legal Business Name): KATHRYN BRANDT RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 SUNSET RDG
CARMEL NY
10512-1133
US

IV. Provider business mailing address

4 SUNSET RDG
CARMEL NY
10512-1133
US

V. Phone/Fax

Practice location:
  • Phone: 845-225-2227
  • Fax: 914-666-1965
Mailing address:
  • Phone: 845-225-2227
  • Fax: 914-666-1965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number034655
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: