Provider Demographics
NPI:1659443901
Name:DBRANT, GARRY RICHARD (DC ND LCSW DA CBN)
Entity Type:Individual
Prefix:DR
First Name:GARRY
Middle Name:RICHARD
Last Name:DBRANT
Suffix:
Gender:M
Credentials:DC ND LCSW DA CBN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CEDAR SWAMP RD
Mailing Address - Street 2:STE 3
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-3746
Mailing Address - Country:US
Mailing Address - Phone:516-609-0890
Mailing Address - Fax:516-609-0893
Practice Address - Street 1:977 GLEN COVE AVE
Practice Address - Street 2:
Practice Address - City:GLEN HEAD
Practice Address - State:NY
Practice Address - Zip Code:11545
Practice Address - Country:US
Practice Address - Phone:516-609-0890
Practice Address - Fax:516-609-0893
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0207061041C0700X
NYR02070611041C0700X
NY0037641133N00000X, 133V00000X
NYX0055941111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
P2537094OtherOXFORD
1046278OtherASH
5897488OtherGHI
7956083OtherAETNA
DG5594OtherATLANTIS
P3161674OtherOXFORD
X8H50OtherEMPIRE
P3105888OtherOXFORD
7956083OtherAETNA