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General NPI Number Information
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NPI Number | 1356734131
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Entity Type | Organization
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Legal Business Name | MICHAEL C BRAUNSTEIN MD PLLC
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Dates
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Enumeration Date | 03/18/2015
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Last Update Date | 03/18/2015
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Provider Practice Location Address
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Address Line | 1111 BROADHOLLOW RD SUITE 205
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City | FARMINGDALE
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State | NY
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Zip | 11735-4820
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Country | US
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Telephone | 631-226-6717
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Fax | 631-226-6793
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Provider Business Mailing Address
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Address Line | 1111 BROADHOLLOW RD SUITE 205
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City | FARMINGDALE
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State | NY
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Zip | 11735-4820
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Country | US
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Telephone | 631-226-6717
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Fax | 631-226-6793
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. MICHAEL BRAUNSTEIN
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Credential | MD
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Telephone | 516-301-7740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 148696
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License Number State | NY
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