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General NPI Number Information
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NPI Number | 1699789693
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Entity Type | Organization
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Legal Business Name | LANDRY & BRANDES MD'S PLC
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 06/10/2010
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Provider Practice Location Address
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Address Line | 1205 NORTH AVE
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City | BURLINGTON
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State | VT
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Zip | 05408-2751
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Country | US
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Telephone | 802-860-3934
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Fax | 802-865-7616
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Provider Business Mailing Address
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Address Line | 1205 NORTH AVE
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City | BURLINGTON
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State | VT
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Zip | 05408-2751
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Country | US
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Telephone | 802-860-3934
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Fax | 802-865-7616
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MJ (MARY JANE) HYDUKE
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Credential |
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Telephone | 802-860-3934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | VT
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