Provider Demographics
NPI:1568509800
Name:BRANDOW, RUTH ANN (MD)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:ANN
Last Name:BRANDOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:BRANDOW
Other - Last Name:DONAHUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 14890
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12212-4890
Mailing Address - Country:US
Mailing Address - Phone:518-525-5634
Mailing Address - Fax:
Practice Address - Street 1:147 HOOSICK ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-2348
Practice Address - Country:US
Practice Address - Phone:518-268-5370
Practice Address - Fax:518-268-5709
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY263330207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400057999Medicare PIN
NYE49842Medicare UPIN