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General NPI Number Information
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NPI Number | 1417451865
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Entity Type | Organization
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Legal Business Name | JEREMY A. BRAUER, MD PC
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Dates
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Enumeration Date | 03/21/2018
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Last Update Date | 03/21/2018
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Provider Practice Location Address
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Address Line | 1035 5TH AVE
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City | NEW YORK
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State | NY
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Zip | 10028-0135
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Country | US
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Telephone | 212-288-8222
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Fax |
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Provider Business Mailing Address
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Address Line | 510 OAKHURST RD
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City | MAMARONECK
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State | NY
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Zip | 10543-4003
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. JEREMY ALEXANDER BRAUER
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Credential | MD
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Telephone | 914-967-2153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State | NY
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