Provider Demographics
NPI:1245266121
Name:D'AMICO, BRENDA (MD)
Entity type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:
Last Name:D'AMICO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 LAMBS LN
Mailing Address - Street 2:
Mailing Address - City:CRESSKILL
Mailing Address - State:NJ
Mailing Address - Zip Code:07626-2250
Mailing Address - Country:US
Mailing Address - Phone:201-320-4844
Mailing Address - Fax:
Practice Address - Street 1:WHITE PLAINS HOSPITA -EMERGENCY DEPARTMENT
Practice Address - Street 2:DAVIS AVE @ E. POST RD
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601
Practice Address - Country:US
Practice Address - Phone:914-681-1155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY146386207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine