Provider Demographics
NPI:1861490823
Name:PARTENZA, BRANDON (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:PARTENZA
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 FRENCH RD
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-1037
Mailing Address - Country:US
Mailing Address - Phone:315-266-0010
Mailing Address - Fax:315-266-0147
Practice Address - Street 1:600 FRENCH RD
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-1037
Practice Address - Country:US
Practice Address - Phone:315-266-0010
Practice Address - Fax:315-266-0147
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015432-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA6903Medicare ID - Type Unspecified