Individual
BRANDON VEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
150 N MIDLAND AVE, SADDLE BROOK, NJ 07663-5926
(201) 992-0177
Mailing address
576 BROADHOLLOW RD, MELVILLE, NY 11747-5002
(631) 359-5859
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00387400
NJ
Other
Enumeration date
09/01/2021
Last updated
09/01/2021
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