Healthcare Provider Details

I. General information

NPI: 1013595842
Provider Name (Legal Business Name): DAREN BRAUDIS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2021
Last Update Date: 04/01/2021
Certification Date: 04/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2656 WILMINGTON RD
NEW CASTLE PA
16105-1547
US

IV. Provider business mailing address

2654 WILMINGTON RD
NEW CASTLE PA
16105-1547
US

V. Phone/Fax

Practice location:
  • Phone: 724-655-3090
  • Fax:
Mailing address:
  • Phone: 724-655-3090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC011633
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: