Organization
JOHN A BRENDESE MD PC
Active
Organization
JOHN A BRENDESE MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ANTHONY BRENDESE MD (PRESIDENT)
(518) 274-2030
Entity
Organization
Contact information
Practice address
2402 22ND STREET, TROY, NY 12180
(518) 274-2030
(518) 274-2030
Mailing address
297 HOOSICK ST, TROY, NY 12180
(518) 272-3493
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
86830
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000029374
GH1
NY
01
—
000406531001
BS OF NORTHEASTERN NY
NY
Enumeration date
08/31/2006
Last updated
10/18/2019
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