Provider Demographics
NPI:1295364636
Name:BRANISH, KATERYNA (MD)
Entity Type:Individual
Prefix:
First Name:KATERYNA
Middle Name:
Last Name:BRANISH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 FRIES MILL RD STE N3
Mailing Address - Street 2:
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-2055
Mailing Address - Country:US
Mailing Address - Phone:856-922-9896
Mailing Address - Fax:856-922-9890
Practice Address - Street 1:188 FRIES MILL RD STE N3
Practice Address - Street 2:
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-2055
Practice Address - Country:US
Practice Address - Phone:856-922-9896
Practice Address - Fax:856-922-9890
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-07
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA11730700207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty