Individual
MS. JILLIAN LOIS BRANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 GUSTAVE L LEVY PL, NEW YORK, NY 10029-6504
(212) 241-6500
Mailing address
30 HAVEMEYER ST, BROOKLYN, NY 11211-2172
(248) 563-2518
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
018041
NY
363AS0400X
Surgical Physician Assistant
Primary
018041
NY
Other
Enumeration date
09/26/2014
Last updated
09/26/2014
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