Individual
THEODORE BRAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
7785 N STATE ST, LOWVILLE, NY 13367-1229
(315) 376-5475
Mailing address
PO BOX 2337, SYRACUSE, NY 13220-2337
(315) 422-2933
(315) 422-3909
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
273665
NY
Other
Enumeration date
07/26/2006
Last updated
10/29/2011
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