Provider Demographics
NPI:1134541873
Name:KERNS, BRANDY (MSED)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:KERNS
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 W 113TH ST APT 1A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-3254
Mailing Address - Country:US
Mailing Address - Phone:203-675-2102
Mailing Address - Fax:
Practice Address - Street 1:309 W 113TH ST APT 1A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-3254
Practice Address - Country:US
Practice Address - Phone:203-675-2102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist