Provider Demographics
NPI:1679563183
Name:BRAND, RICHARD R (PHD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:R
Last Name:BRAND
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 STAGE RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-3513
Mailing Address - Country:US
Mailing Address - Phone:845-782-0408
Mailing Address - Fax:845-353-2929
Practice Address - Street 1:106 STAGE RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-3513
Practice Address - Country:US
Practice Address - Phone:845-782-0408
Practice Address - Fax:845-353-2929
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004635-1103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV07902Medicare ID - Type Unspecified