Provider Demographics
NPI:1942580105
Name:NEUBRANDER, JUSTIN LEE (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:LEE
Last Name:NEUBRANDER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:100 MENLO PARK STE 410
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-2428
Mailing Address - Country:US
Mailing Address - Phone:732-906-9000
Mailing Address - Fax:732-906-9015
Practice Address - Street 1:100 MENLO PARK STE 410
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-2428
Practice Address - Country:US
Practice Address - Phone:732-906-9000
Practice Address - Fax:732-906-9015
Is Sole Proprietor?:No
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00263000363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical