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General NPI Number Information
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NPI Number | 1558632547
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Entity Type | Organization
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Legal Business Name | DR. ELLEN BRAUNSTEIN, MD, PC
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Dates
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Enumeration Date | 01/23/2012
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Last Update Date | 01/23/2012
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Provider Practice Location Address
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Address Line | 949 CENTRAL AVE SUITE 100
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City | WOODMERE
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State | NY
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Zip | 11598-1204
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Country | US
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Telephone | 516-374-7246
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Fax | 516-374-4408
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Provider Business Mailing Address
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Address Line | 949 CENTRAL AVE SUITE 100
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City | WOODMERE
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State | NY
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Zip | 11598-1204
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Country | US
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Telephone | 516-374-7246
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Fax | 516-374-4408
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Authorized Official
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Title or Position | DOCTOR/NEUROLOGIST
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Name | DR. ELLEN JOY BRAUNSTEIN
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Credential | M.D.
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Telephone | 516-374-7246
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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 | 157489-1
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License Number State | NY
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