Wander Braga, MD
Individual provider Active NPI Child & Adolescent Psychiatry Physician · Schoharie, NY
NPI 1720151533 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720151533
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Child & Adolescent Psychiatry Physician 2084P0804X
- License
- 116066 (NY)
- Practice address
- 284 Main St
Suite 320
Schoharie, NY 12157 - Phone
- (518) 295-8336
- NPI assigned
- Nov 17, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 116066 | NY | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Schoharie County | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 116066 | NY | Yes |
Addresses
Primary practice location
284 Main St
Suite 320
Schoharie, NY 12157
Mailing address
284 Main St
Suite 320
Schoharie, NY 12157
Phone (518) 295-8336
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00555784 | Medicaid | NY |
Other providers in Schoharie, NY
- Tracy Baran
- Bassett Healthcare Schoharie
- Warren A Becker
- Christine E Binkley
- Michele Leigh Borst
- Leigh Bulka
- Bradley Ronald Bush
- Cathleen Buskey
- Amanda L Cain
- Nicole Camporese
All providers in Schoharie, NY · Child & Adolescent Psychiatry Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.