Provider Demographics
NPI:1326358805
Name:ZUCHOWSKI, BRANDON JOSEPH (PA-C)
Entity Type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:JOSEPH
Last Name:ZUCHOWSKI
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 E RIVER ST
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-5902
Mailing Address - Country:US
Mailing Address - Phone:440-465-2963
Mailing Address - Fax:
Practice Address - Street 1:5001 TRANSPORTATION DR STE 200
Practice Address - Street 2:
Practice Address - City:SHEFFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44054-2850
Practice Address - Country:US
Practice Address - Phone:440-328-3444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.003183363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1095205OtherNCCPA
OH50.003183OtherOHIO STATE MEDICAL BOARD