Basic Information
| Provider Information | |||||||||
| NPI: | 1861646259 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VINT | ||||||||
| FirstName: | BRANDAN | ||||||||
| MiddleName: | PATRICK | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 505 4TH ST | ||||||||
| Address2: | 313 | ||||||||
| City: | HOBOKEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070302697 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2127592211 | ||||||||
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| Practice Location | |||||||||
| Address1: | 120 E 56TH ST | ||||||||
| Address2: | 1010 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100223607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2127582211 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/11/2008 | ||||||||
| LastUpdateDate: | 11/11/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 030693-1 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.