Provider Demographics
NPI:1609939651
Name:BRAVERMAN, ALBERT STUART (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:STUART
Last Name:BRAVERMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:270 RIVERSIDE DR
Mailing Address - Street 2:APT 11A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5209
Mailing Address - Country:US
Mailing Address - Phone:212-662-4432
Mailing Address - Fax:718-270-1544
Practice Address - Street 1:451 CLARKSON AVE
Practice Address - Street 2:A22 CLINICS
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2057
Practice Address - Country:US
Practice Address - Phone:718-270-2559
Practice Address - Fax:718-270-1544
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-09
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Provider Licenses
StateLicense IDTaxonomies
NY090636207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY090636OtherLICENSE
NY090636OtherLICENSE