Provider Demographics
NPI:1538307020
Name:BRANT-DEITCH, DEBORAH HELEN (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:HELEN
Last Name:BRANT-DEITCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6134 188TH ST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-2726
Mailing Address - Country:US
Mailing Address - Phone:718-454-5500
Mailing Address - Fax:718-454-3500
Practice Address - Street 1:6134 188TH ST
Practice Address - Street 2:SUITE 211
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-2726
Practice Address - Country:US
Practice Address - Phone:718-454-5500
Practice Address - Fax:718-454-3500
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY271937208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics