Provider Demographics
NPI:1144400847
Name:KATHY KAHN-BRANDES MD PLLC
Entity type:Organization
Organization Name:KATHY KAHN-BRANDES MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHN-BRANDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-546-6627
Mailing Address - Street 1:1991 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-3464
Mailing Address - Country:US
Mailing Address - Phone:516-546-6627
Mailing Address - Fax:516-546-5237
Practice Address - Street 1:560 NORTHERN BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5100
Practice Address - Country:US
Practice Address - Phone:516-504-1600
Practice Address - Fax:516-504-6398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179762174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWBJ541Medicare PIN