Provider Demographics
NPI:1730149501
Name:BRAUNER, GARY JULES (MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:JULES
Last Name:BRAUNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 WILSON DRIVE
Mailing Address - Street 2:
Mailing Address - City:CRESSKILL
Mailing Address - State:NJ
Mailing Address - Zip Code:07626
Mailing Address - Country:US
Mailing Address - Phone:201-637-1064
Mailing Address - Fax:201-871-0909
Practice Address - Street 1:231 WILSON DRIVE
Practice Address - Street 2:
Practice Address - City:CRESSKILL
Practice Address - State:NJ
Practice Address - Zip Code:07626
Practice Address - Country:US
Practice Address - Phone:212-421-5080
Practice Address - Fax:201-871-0909
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY109440207NS0135X, 207N00000X, 207NP0225X
NJ25MA03018200207NS0135X, 207NP0225X, 207N00000X, 207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY702521Medicare ID - Type Unspecified
B18828Medicare UPIN
NJ095958Medicare ID - Type Unspecified