Provider Demographics
NPI:1023834538
Name:BRAINE, BRETT
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:BRAINE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4110 MAPLECREST AVE
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44134-3522
Mailing Address - Country:US
Mailing Address - Phone:440-623-1767
Mailing Address - Fax:
Practice Address - Street 1:4110 MAPLECREST AVE
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44134-3522
Practice Address - Country:US
Practice Address - Phone:440-623-1767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-29
Last Update Date:2024-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No171WH0202XOther Service ProvidersContractorHome Modifications
No172A00000XOther Service ProvidersDriver
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant