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General NPI Number Information
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NPI Number | 1417393000
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Entity Type | Organization
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Legal Business Name | BRANNING PODIATRY, PC
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Dates
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Enumeration Date | 05/22/2013
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Last Update Date | 05/22/2013
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Provider Practice Location Address
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Address Line | 310 SUNRISE AVE SUITE B
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City | HONESDALE
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State | PA
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Zip | 18431-1032
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Country | US
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Telephone | 570-352-3668
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Fax | 570-352-3669
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Provider Business Mailing Address
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Address Line | 310 SUNRISE AVE SUITE B
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City | HONESDALE
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State | PA
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Zip | 18431-0509
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Country | US
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Telephone | 570-352-3668
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Fax | 570-352-3669
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NICOLE MARIE BRANNING
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Credential | DPM
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Telephone | 570-352-3668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | SC005984
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License Number State | PA
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