Provider Demographics
NPI:1548329741
Name:YEHL, BRANDON A (RPA-C)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:A
Last Name:YEHL
Suffix:
Gender:M
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 OAKLAND ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-2415
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 CANAL VIEW BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-2852
Practice Address - Country:US
Practice Address - Phone:585-461-5330
Practice Address - Fax:585-461-9895
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011640363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical