MEDICARE: DR. GARY JULES BRAUNER 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	207NS0135X	Procedural Dermatology Physician	109440	NY
2	207NS0135X	Procedural Dermatology Physician	25MA03018200	NJ
3	207N00000X	Dermatology Physician	109440	NY
4	207NP0225X	Pediatric Dermatology Physician	25MA03018200	NJ
5	207N00000X	Dermatology Physician	25MA03018200	NJ
6	207ND0900X	Dermatopathology Physician	25MA03018200	NJ
7	207NP0225X	Pediatric Dermatology Physician	109440	NY

General Provider Information

NPI Number	:	1730149501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY JULES BRAUNER MD

Provider Business Mailing Address
First Line	:	231 WILSON DRIVE
Second Line	:
City	:	CRESSKILL
State	:	NJ
Zip	:	07626
Country	:	US
Telephone Number	:	201-637-1064
Fax Number	:	201-871-0909

Provider Business Practice Location Address
First Line	:	231 WILSON DRIVE
Second Line	:
City	:	CRESSKILL
State	:	NJ
Zip	:	07626
Country	:	US
Telephone Number	:	212-421-5080
Fax Number	:	201-871-0909

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

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	05/09/2025

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