Individual
BRANDON A MACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1114 RARITAN RD, CLARK, NJ 07066-1330
(732) 382-3470
(732) 301-8262
Mailing address
1114 RARITAN RD, CLARK, NJ 07066-1330
(732) 382-3470
(732) 301-8262
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
25MD00126200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3057101
—
NJ
Enumeration date
06/17/2005
Last updated
09/20/2011
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