Individual
BREANNA NICOLE VANDYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
140 HAMMOND ST, PORT JERVIS, NY 12771-2607
(845) 563-8000
Mailing address
2570 ROUTE 9W STE 10, CORNWALL, NY 12518-1370
(845) 220-3100
(845) 534-2940
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
355846
NY
Other
Enumeration date
06/06/2023
Last updated
03/11/2025
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