Basic Information
Provider Information
NPI: 1679806772
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BRANDWEIN
FirstName: ARIEL
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 506 6TH ST
Address2:  
City: BROOKLYN
State: NY
PostalCode: 112153609
CountryCode: US
TelephoneNumber: 7187803000
FaxNumber:  
Practice Location
Address1: 506 6TH ST
Address2:  
City: BROOKLYN
State: NY
PostalCode: 112153609
CountryCode: US
TelephoneNumber: 7187803000
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/09/2009
LastUpdateDate: 06/11/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/11/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0203X267654NYY Allopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine

No ID Information.


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