Provider Demographics
NPI:1407949563
Name:MACPHERSON, BRANT M
Entity Type:Individual
Prefix:
First Name:BRANT
Middle Name:M
Last Name:MACPHERSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 UNDERHILL AVENUE
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791
Mailing Address - Country:US
Mailing Address - Phone:516-496-8420
Mailing Address - Fax:516-741-8051
Practice Address - Street 1:137 WILLIS AVENUE
Practice Address - Street 2:NASSAU REHABILITATION & SPORTS THERAPY PC
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501
Practice Address - Country:US
Practice Address - Phone:516-741-9600
Practice Address - Fax:516-741-8051
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist