MEDICARE: DR. NICHOLAS BRABANDER PHARM.D.

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	1835P1200X	Pharmacotherapy Pharmacist	RP037061R	PA

General Provider Information

NPI Number	:	1821078775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICHOLAS BRABANDER PHARM.D.

Provider Business Mailing Address
First Line	:	255 PATTON RD
Second Line	:
City	:	DANVILLE
State	:	PA
Zip	:	17821-7517
Country	:	US
Telephone Number	:	570-271-1083
Fax Number	:

Provider Business Practice Location Address
First Line	:	GEISINGER MEDICAL CENTER 100 N ACADEMY AVE
Second Line	:	SYSTEM THERAPEUTICS 42-01
City	:	DANVILLE
State	:	PA
Zip	:	17822-0001
Country	:	US
Telephone Number	:	570-271-5594
Fax Number	:

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

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	07/08/2007

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