MEDICARE: LORI M BRAND-ABEND MD

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
1	2085R0202X	Diagnostic Radiology Physician	25MA05300500	NJ
2	2085B0100X	Body Imaging Physician	25MA05300500	NJ
3	208D00000X	General Practice Physician	25MA05300500	NJ

General Provider Information

NPI Number	:	1184606329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI M BRAND-ABEND MD

Provider Business Mailing Address
First Line	:	35 OLCOTT SQ
Second Line	:
City	:	BERNARDSVILLE
State	:	NJ
Zip	:	07924-2326
Country	:	US
Telephone Number	:	908-766-2730
Fax Number	:

Provider Business Practice Location Address
First Line	:	35 OLCOTT SQ
Second Line	:
City	:	BERNARDSVILLE
State	:	NJ
Zip	:	07924-2326
Country	:	US
Telephone Number	:	908-766-2730
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2005
Last Update Date	:	01/04/2016

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