Provider Demographics
NPI:1336251370
Name:BRANDWEIN, CHARLES JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:JAY
Last Name:BRANDWEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 CURTIS PL
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-3204
Mailing Address - Country:US
Mailing Address - Phone:732-297-9353
Mailing Address - Fax:
Practice Address - Street 1:561 CRANBURY RD
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816
Practice Address - Country:US
Practice Address - Phone:732-238-4993
Practice Address - Fax:732-390-1751
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02062800207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
4204500OtherAETNA
OK1890OtherHEALTHNET
010640400OtherAMERIHEALTH
010640400OtherAMERIHEALTH
4204500OtherAETNA
F05022Medicare UPIN