Provider Demographics
NPI:1639454184
Name:VERNI BRANDL, MARIA
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:
Last Name:VERNI BRANDL
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:VERNI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8544 212TH ST
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-1341
Mailing Address - Country:US
Mailing Address - Phone:718-465-7068
Mailing Address - Fax:
Practice Address - Street 1:73 COVERT AVE
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-3218
Practice Address - Country:US
Practice Address - Phone:516-354-1227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0426242183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist