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Individual

DENISE MARIE BRANNICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1500 N JAMES ST, ROME, NY 13440-2844
(315) 338-7029
Mailing address
185 GENESEE ST, SUITE 600, UTICA, NY 13501-2199
(315) 793-8806
(315) 793-8046

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
199317
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01647929
NY
05
01650540
NY
01
040426013911
FIDELIS
NY
01
10045916
CDPHP
NY
01
199317-9
WC
NY
01
225083
MVP
NY
01
300083371
RAIL ROAD MEDICARE
NY
01
4102996
GHI
NY
01
P010199317
BCBS
NY
Enumeration date
05/04/2006
Last updated
05/01/2023
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