Provider Demographics
NPI:1619604337
Name:BRAND NEW DAY, LLC
Entity Type:Organization
Organization Name:BRAND NEW DAY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:410-271-6747
Mailing Address - Street 1:313 E COMMERCIAL AVE UNIT C
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:IN
Mailing Address - Zip Code:46356-1707
Mailing Address - Country:US
Mailing Address - Phone:410-271-6747
Mailing Address - Fax:
Practice Address - Street 1:313 E COMMERCIAL AVE UNIT C
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:IN
Practice Address - Zip Code:46356-1707
Practice Address - Country:US
Practice Address - Phone:410-271-6747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty