Basic Information
| Provider Information | |||||||||
| NPI: | 1619293313 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEBOW | ||||||||
| FirstName: | BRANDON | ||||||||
| MiddleName: | FORD | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 ELMWOOD AVE | ||||||||
| Address2: | BOX 604 | ||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146420001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5852751385 | ||||||||
| FaxNumber: | 5852447271 | ||||||||
| Practice Location | |||||||||
| Address1: | 201 E UNIVERSITY PKWY | ||||||||
| Address2: | DEPT OF MEDICINE | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212182829 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105546755 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2010 | ||||||||
| LastUpdateDate: | 09/30/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 279379 | NY | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.