Provider Demographics
NPI:1396632725
Name:LAVENTURE, BRANDON JOSEPH (PA-C)
Entity type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:JOSEPH
Last Name:LAVENTURE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1128 BAKER AVE
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12309-5710
Mailing Address - Country:US
Mailing Address - Phone:518-836-4036
Mailing Address - Fax:
Practice Address - Street 1:315 S MANNING BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-1789
Practice Address - Country:US
Practice Address - Phone:518-454-1550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant