Individual
GWEN ORR BRACHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
30 BERGEN ST, ADMC 12 1205, NEWARK, NJ 07107-3000
(973) 972-0037
(973) 972-9355
Mailing address
30 BERGEN ST, ADMC 12 1205, NEWARK, NJ 07107-3000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA04674100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6639003
—
NJ
Enumeration date
05/10/2007
Last updated
07/10/2009
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