Provider Demographics
NPI:1508394511
Name:MCDERMOTT, BRENDAN PATRICK (ATC)
Entity Type:Individual
Prefix:MR
First Name:BRENDAN
Middle Name:PATRICK
Last Name:MCDERMOTT
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 ACKER DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-1614
Mailing Address - Country:US
Mailing Address - Phone:732-882-6989
Mailing Address - Fax:
Practice Address - Street 1:33 ACKER DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NJ
Practice Address - Zip Code:07748-1614
Practice Address - Country:US
Practice Address - Phone:732-882-6989
Practice Address - Fax:732-882-6989
Is Sole Proprietor?:No
Enumeration Date:2017-06-03
Last Update Date:2017-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer