Individual
BRANDON KEITH MADISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6424 18TH AVE, BROOKLYN, NY 11204-3729
(212) 687-7464
Mailing address
6424 18TH AVE, BROOKLYN, NY 11204-3729
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
342735
NY
Other
Enumeration date
04/28/2022
Last updated
04/28/2022
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