Provider Demographics
NPI:1255736864
Name:KORDZIEL, BRANDI
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:KORDZIEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 NORRISVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SCHUYLER FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12985-2512
Mailing Address - Country:US
Mailing Address - Phone:518-410-0993
Mailing Address - Fax:
Practice Address - Street 1:363 NORRISVILLE RD
Practice Address - Street 2:
Practice Address - City:SCHUYLER FALLS
Practice Address - State:NY
Practice Address - Zip Code:12985-2512
Practice Address - Country:US
Practice Address - Phone:518-410-0993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY692871163W00000X, 163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine