Provider Demographics
NPI:1275834020
Name:BRANDT-RAUF, PAUL WESLEY (MD)
Entity Type:Individual
Prefix:PROF
First Name:PAUL
Middle Name:WESLEY
Last Name:BRANDT-RAUF
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 1:40 MICHAEL DR
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-6710
Mailing Address - Country:US
Mailing Address - Phone:646-417-4250
Mailing Address - Fax:
Practice Address - Street 1:40 MICHAEL DR
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-6710
Practice Address - Country:US
Practice Address - Phone:646-417-4250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-10
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY143020207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine