Individual
BRANDON T WOLFENDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
110 W 6TH ST, OSWEGO, NY 13126-2507
(315) 349-5511
(315) 349-5732
Mailing address
75 REMIT DR # 6151, CHICAGO, IL 60675-6151
(866) 916-5259
(231) 922-4030
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
P72949
NY
363A00000X
Physician Assistant
Primary
013588-1
NY
363A00000X
Physician Assistant
P72949
NY
Other
Enumeration date
09/11/2009
Last updated
04/07/2025
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