Healthcare Provider Details

I. General information

NPI: 1174107080
Provider Name (Legal Business Name): BRANDON TOWEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2021
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 LEACH RD
LYONS NY
14489-9732
US

IV. Provider business mailing address

12 LEACH RD
LYONS NY
14489-9732
US

V. Phone/Fax

Practice location:
  • Phone: 315-787-5300
  • Fax: 315-362-3275
Mailing address:
  • Phone: 315-787-5300
  • Fax: 315-362-3275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number333363
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: