John a Brendese MD PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

86830 Issued in NY

Legal business name

JOHN A BRENDESE MD PC

Practice address

2402 22ND Street
Troy, NY 12180

Phone

(518) 274-2030

Fax

(518) 274-2030

NPI assigned

Aug 31, 2006

Last updated

Oct 18, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Anthony Brendese, MD

Title

President

Phone

(518) 274-2030

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571356800000",
    "number": "1871605394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 HOOSICK ST",
            "city": "TROY",
            "state": "NY",
            "postal_code": "12180",
            "telephone_number": "518-272-3493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 22ND STREET",
            "city": "TROY",
            "state": "NY",
            "postal_code": "12180",
            "telephone_number": "518-274-2030",
            "fax_number": "518-274-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN A BRENDESE MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2019-10-18",
        "status": "A",
        "authorized_official_last_name": "BRENDESE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-274-2030",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "NY",
            "license": "86830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GH1",
            "identifier": "000000029374",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS OF NORTHEASTERN NY",
            "identifier": "000406531001",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Ogonowski, OD, PLLC
• Pierrot Jeannot, MD
• Carole A Jenks
• Shawn Bradley Jeune, NP
• Migdalia Jimenez, RN
• John E Crable DDS PC
• Alan Joseph Johnson Jr., PT
• Carol Johnson
• Deyonia J Johnson
• Stacey A Johnson

• Dermatology Physician in Troy, NY
• Providers in Troy, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.