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Individual

MR. DARYL ADRIAN BRANDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
522 MANILA AVENUE, APT 1, JERSEY CITY, NJ 07302
(201) 993-9654
Mailing address
522 MANILA AVENUE, APT 1, JERSEY CITY, NJ 07302
(201) 659-7687

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
146808
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02229023
NY
Enumeration date
08/08/2007
Last updated
02/23/2010
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  • EDI platform