Individual
BRANT FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001840
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02799773
—
NY
01
—
P00424698
RAILROAD MEDICARE
NY
Enumeration date
06/05/2006
Last updated
08/27/2013
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