Provider Demographics
NPI:1083658801
Name:BRANDEL, ZEV (MD)
Entity type:Individual
Prefix:DR
First Name:ZEV
Middle Name:
Last Name:BRANDEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2504 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-3538
Mailing Address - Country:US
Mailing Address - Phone:516-868-3080
Mailing Address - Fax:516-771-6851
Practice Address - Street 1:2504 GRAND AVE
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-3538
Practice Address - Country:US
Practice Address - Phone:516-868-3080
Practice Address - Fax:516-771-6851
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2070191207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG55123Medicare UPIN
NY00V182Medicare PIN