Healthcare Provider Details

I. General information

NPI: 1336985209
Provider Name (Legal Business Name): BRANDON ROBINSON FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2024
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

297 SPINDRIFT DR STE 100
WILLIAMSVILLE NY
14221-7894
US

IV. Provider business mailing address

297 SPINDRIFT DR STE 100
WILLIAMSVILLE NY
14221-7894
US

V. Phone/Fax

Practice location:
  • Phone: 716-831-2600
  • Fax:
Mailing address:
  • Phone: 716-831-2600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number354646
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF354646-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: