Provider Demographics
NPI:1275683120
Name:BRANDE, JEFFERY LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:LEE
Last Name:BRANDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 W 67TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-6241
Mailing Address - Country:US
Mailing Address - Phone:212-873-7302
Mailing Address - Fax:212-873-0396
Practice Address - Street 1:2 W 67TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-6241
Practice Address - Country:US
Practice Address - Phone:212-873-7302
Practice Address - Fax:212-873-0396
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY186640208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery