Brandt, Wade Jason

Brandt, Wade Jason is an individual health care provider with primary practice located at 1200 Driving Park Ave , Newark NY 14513. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is his primary health care specialty. Brandt, Wade Jason can be contacted via phone (315) 359-2123.

Contact Information

Primary practice address
1200 Driving Park Ave Newark NY 14513
Phone: (315) 359-2123
Fax: (315) 359-2167
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R038406ANDCP000642 South Dakota
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 201802902NP-PP Oregon
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 344384 New York

Profile Details

NPI number 1629070297
LBN Legal business name Brandt, Wade Jason
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2005
Last updated Oct 24th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629070297 NPPES
Oregon MEDICAID 500704675

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