Provider Demographics
NPI:1669895652
Name:SARACENO, BRANDON JEFFREY (DC)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:JEFFREY
Last Name:SARACENO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 DUNDON RD
Mailing Address - Street 2:APT. 1
Mailing Address - City:EDINBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16412-2322
Mailing Address - Country:US
Mailing Address - Phone:814-746-2836
Mailing Address - Fax:
Practice Address - Street 1:1009 E 38TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16504-1843
Practice Address - Country:US
Practice Address - Phone:814-824-6442
Practice Address - Fax:814-824-4007
Is Sole Proprietor?:No
Enumeration Date:2014-01-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010804111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor