MEDICARE: DR. LAUREN BRANDES 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	2084N0400X	Neurology Physician	036.152681	IL

General Provider Information

NPI Number	:	1396190203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAUREN BRANDES MD

Provider Business Mailing Address
First Line	:	97 AMITY ST FL 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-6004
Country	:	US
Telephone Number	:	929-455-2500
Fax Number	:

Provider Business Practice Location Address
First Line	:	70 ATLANTIC AVE FL 4
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-5501
Country	:	US
Telephone Number	:	929-455-2500
Fax Number	:

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

Provider Enumeration Date	:	04/28/2016
Last Update Date	:	04/03/2023

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