Provider Demographics
NPI:1912785858
Name:SCHNELL, BRANDON A (PAC)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:A
Last Name:SCHNELL
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 ST LUKES DR
Mailing Address - Street 2:
Mailing Address - City:LEHIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:18235-5000
Mailing Address - Country:US
Mailing Address - Phone:484-526-4500
Mailing Address - Fax:484-526-6674
Practice Address - Street 1:500 ST LUKES DR
Practice Address - Street 2:
Practice Address - City:LEHIGHTON
Practice Address - State:PA
Practice Address - Zip Code:18235-5000
Practice Address - Country:US
Practice Address - Phone:484-526-4500
Practice Address - Fax:484-526-6674
Is Sole Proprietor?:No
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA064977363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant