Provider Demographics
NPI:1548231814
Name:BRANDEISKY, JOHN ARTHUR (DPM)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ARTHUR
Last Name:BRANDEISKY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4249 US HIGHWAY 9
Mailing Address - Street 2:FREEHOLD OFFICE PLAZA
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-8308
Mailing Address - Country:US
Mailing Address - Phone:732-308-1090
Mailing Address - Fax:732-308-1143
Practice Address - Street 1:4249 US HIGHWAY 9
Practice Address - Street 2:FREEHOLD OFFICE PLAZA
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-8308
Practice Address - Country:US
Practice Address - Phone:732-308-1090
Practice Address - Fax:732-308-1143
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MD00169400213E00000X, 213EP1101X, 213ES0000X, 213ES0103X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJBR508624Medicare ID - Type Unspecified
NJT45629Medicare UPIN