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General NPI Number Information
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NPI Number | 1154979078
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Entity Type | Individual
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Provider Name | BRANDT AYMOND PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/04/2019
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Last Update Date | 09/04/2019
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Provider Practice Location Address
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Address Line | 545 OAKLAWN DR
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City | METAIRIE
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State | LA
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Zip | 70005-2808
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Country | US
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Telephone | 504-336-2515
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Fax |
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Provider Business Mailing Address
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Address Line | 3921 CLERMONT DR
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City | NEW ORLEANS
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State | LA
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Zip | 70122-4811
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Country | US
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Telephone | 337-323-9684
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 320372
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License Number State | LA
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