Individual
DR. MARK LEONARD BRANDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11 RALPH PL, SUITE 102, STATEN ISLAND, NY 10304-4401
(718) 447-6545
(718) 447-5297
Mailing address
11 RALPH PL, SUITE 102, STATEN ISLAND, NY 10304-4401
(718) 447-6545
(718) 447-5297
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
238123
NY
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
25MA08490300
NJ
Other
Enumeration date
10/28/2008
Last updated
04/04/2013
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