Provider Demographics
NPI:1477792950
Name:BRANDT, LINDA ANN (CPHT)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:ANN
Last Name:BRANDT
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RT 9 G
Mailing Address - Street 2:
Mailing Address - City:CASTLE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:12511
Mailing Address - Country:US
Mailing Address - Phone:845-831-2000
Mailing Address - Fax:
Practice Address - Street 1:RT 9 G
Practice Address - Street 2:
Practice Address - City:CASTLE POINT
Practice Address - State:NY
Practice Address - Zip Code:12511
Practice Address - Country:US
Practice Address - Phone:845-831-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-06
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY209201146N00000X
4401-0108-0561-905183700000X
ILMLT 006748246RM2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical Laboratory