Provider Demographics
NPI:1992858724
Name:BRANDMAN, BEVERLY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:
Last Name:BRANDMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 SELMA COURT
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731
Mailing Address - Country:US
Mailing Address - Phone:516-869-8327
Mailing Address - Fax:631-499-5909
Practice Address - Street 1:1025 NORTHERN BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576
Practice Address - Country:US
Practice Address - Phone:516-869-8327
Practice Address - Fax:631-499-5909
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0327701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN16781Medicare ID - Type Unspecified