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NPI Code Detail

MEDICARE: LILY TANG BRANDSTETTER PA

MEDICARE: LILY TANG BRANDSTETTER PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician12426GA
2363A00000XPhysician Assistant0010-12574NC
3363A00000XPhysician Assistant12426GA

General Provider Information

NPI Number : 1144953647
Entity Type Code : Individual
Provider Name (Legal Business Name) : LILY TANG BRANDSTETTER PA
Provider Business Mailing Address
First Line : 35 COLLIER RD NW STE 670
Second Line :
City : ATLANTA
State : GA
Zip : 30309-1613
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1968 PEACHTREE RD NW
Second Line :
City : ATLANTA
State : GA
Zip : 30309-1281
Country : US
Telephone Number : 404-367-3014
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2022
Last Update Date : 04/28/2026

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Directions to “ LILY TANG BRANDSTETTER PA” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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