Provider Demographics
NPI:1770845695
Name:BRAND, SARAH LYNN
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:LYNN
Last Name:BRAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 RAINTREE IS APT 12
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-2785
Mailing Address - Country:US
Mailing Address - Phone:518-330-9634
Mailing Address - Fax:
Practice Address - Street 1:1 DELAWARE RD
Practice Address - Street 2:#2
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14217-2743
Practice Address - Country:US
Practice Address - Phone:716-876-3901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY54622711174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist