Provider Demographics
NPI:1225074669
Name:BRAUNSTEIN, DAVID (M D)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:BRAUNSTEIN
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-2312
Mailing Address - Country:US
Mailing Address - Phone:516-295-0529
Mailing Address - Fax:
Practice Address - Street 1:67 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-2312
Practice Address - Country:US
Practice Address - Phone:516-295-0529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1518932085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01165939Medicaid
NYE87338Medicare UPIN
NY01165939Medicaid