Provider Demographics
NPI:1548849938
Name:BRANDT, JANETTA (MD)
Entity type:Individual
Prefix:DR
First Name:JANETTA
Middle Name:
Last Name:BRANDT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JANETTA
Other - Middle Name:
Other - Last Name:BRANDT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:120 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-5733
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:120 MAIN ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-5733
Practice Address - Country:US
Practice Address - Phone:609-635-2559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA12542000207Q00000X
CAA196702208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist