Brandon Israel

Individual provider Active NPI Athletic Trainer · Plainsboro, NJ

NPI 1700199767 · NPPES record last updated Jul 20, 2010

Key facts

NPI
1700199767
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
147952 (NJ)
Practice address
307 Fox Run Dr
Plainsboro, NJ 08536-2637
Phone
(908) 294-4624
NPI assigned
Jul 20, 2010
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
147952NJMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 147952 NJ Yes

Addresses

Primary practice location

307 Fox Run Dr
Plainsboro, NJ 08536-2637

Mailing address

307 Fox Run Dr
Plainsboro, NJ 08536-2637
Phone (908) 294-4624

Other providers in Plainsboro, NJ

All providers in Plainsboro, NJ · Athletic Trainer in New Jersey

Sources for this page

Verify at the official NPI Registry.