Basic Information
Provider Information | |||||||||
NPI: | 1437107000 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | STEIN | ||||||||
FirstName: | BRANDI | ||||||||
MiddleName: | S. | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | PA-C | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | DAY | ||||||||
OtherFirstName: | BRANDI | ||||||||
OtherMiddleName: | S. | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | PA-C | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 699 E STATE ST | ||||||||
Address2: |   | ||||||||
City: | SHARON | ||||||||
State: | PA | ||||||||
PostalCode: | 161462057 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7249833820 | ||||||||
FaxNumber: | 7249833941 | ||||||||
Practice Location | |||||||||
Address1: | 740 E STATE ST | ||||||||
Address2: |   | ||||||||
City: | SHARON | ||||||||
State: | PA | ||||||||
PostalCode: | 161463328 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7249833924 | ||||||||
FaxNumber: | 7249835661 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/05/2006 | ||||||||
LastUpdateDate: | 07/09/2007 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | MA052307 | PA | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |   |
No ID Information.