Provider Demographics
NPI:1811607013
Name:OLOWIANY, BRANDON PATRICK (DC)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:PATRICK
Last Name:OLOWIANY
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 1:200 NEPTUNE DR
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-1751
Mailing Address - Country:US
Mailing Address - Phone:732-267-7810
Mailing Address - Fax:
Practice Address - Street 1:424 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FORKED RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08731-4654
Practice Address - Country:US
Practice Address - Phone:609-971-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00795400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor