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Individual

BRANDON JAMES FORMOZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
50 LEROY ST, POTSDAM, NY 13676-1786
(585) 236-0373
Mailing address
24 SOBER ST, NORFOLK, NY 13667-4147
(315) 663-7791

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
034031
NY

Other

Enumeration date
07/17/2025
Last updated
07/17/2025
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