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General NPI Number Information
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NPI Number | 1972177053
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Entity Type | Individual
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Provider Name | DONNA MARIE BRANT
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Gender | Female
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Dates
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Enumeration Date | 05/13/2021
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Last Update Date | 07/17/2023
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Provider Practice Location Address
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Address Line | 160 SAWGRASS DR STE 150
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City | ROCHESTER
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State | NY
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Zip | 14620-4655
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Country | US
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Telephone | 585-262-9150
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Fax |
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Provider Business Mailing Address
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Address Line | 195 MERRICK ST
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City | ROCHESTER
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State | NY
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Zip | 14615-2666
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Country | US
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Telephone | 585-755-2303
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 347210
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F347210-01
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License Number State | NY
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