Provider Demographics
NPI:1548418429
Name:BRANDOFF, NEAL I (DO)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:I
Last Name:BRANDOFF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:749 CORINTHIAN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-2614
Mailing Address - Country:US
Mailing Address - Phone:215-232-0158
Mailing Address - Fax:
Practice Address - Street 1:749 CORINTHIAN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-2614
Practice Address - Country:US
Practice Address - Phone:215-232-0158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS002846L2084P0800X
NJ25MB025971002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry