Healthcare Provider Details

I. General information

NPI: 1922442326
Provider Name (Legal Business Name): BRENDEN RAYMOND YEE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2013
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 MEETING HOUSE LN
SOUTHAMPTON NY
11968-5009
US

IV. Provider business mailing address

240 MEETING HOUSE LN
SOUTHAMPTON NY
11968-5009
US

V. Phone/Fax

Practice location:
  • Phone: 631-726-8200
  • Fax:
Mailing address:
  • Phone: 631-726-1126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: