Healthcare Provider Details

I. General information

NPI: 1326307653
Provider Name (Legal Business Name): MINDY RACHEL BRITTNER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2012
Last Update Date: 05/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1824 MADISON AVE
NEW YORK NY
10035
US

IV. Provider business mailing address

1824 MADISON AVE
NEW YORK NY
10035-3832
US

V. Phone/Fax

Practice location:
  • Phone: 212-423-4500
  • Fax:
Mailing address:
  • Phone: 973-879-9191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License Number280000
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number280000
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: