Healthcare Provider Details

I. General information

NPI: 1770549255
Provider Name (Legal Business Name): MONICA BRANE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 04/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 MAIN ST
ONEONTA NY
13820-2531
US

IV. Provider business mailing address

PO BOX 725
COOPERSTOWN NY
13326-0725
US

V. Phone/Fax

Practice location:
  • Phone: 607-433-1792
  • Fax: 607-433-6608
Mailing address:
  • Phone: 607-433-1792
  • Fax: 607-433-6608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number211262
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: