National Provider Identifier
Wade Jason Brandt, CNP
Wade Jason Brandt, CNP is listed in the NPPES registry with a primary specialty of Family Nurse Practitioner in Newark, NY and a listed phone number of (315) 359-2123.
Profile Overview
- NPI
- 1629070297
- Provider Type
- Individual
- Primary Specialty
- Family Nurse Practitioner
- Enumeration Date
- August 12, 2005
- Last Updated
- October 24, 2019
Practice Location
- 1200 Driving Park Ave
- Newark, NY 14513
Phone: (315) 359-2123
Mailing Address
- 100 Kings Hwy S
- Rochester, NY 14617-5504
Specialties
- Family Nurse Practitioner (363LF0000X)
- Family Nurse Practitioner (363LF0000X)
- Nurse Practitioner (363L00000X)
Full Record
- NPI
- 1629070297
- Entity Type
- Individual
- Last Name
- Brandt
- First Name
- Wade
- Middle Name
- Jason
- Name Prefix
- Dr.
- Credential
- CNP
- Mailing Street Address
- 100 Kings Hwy S
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14617-5504
- Mailing Country
- US
- Mailing Phone
- (315) 359-2123
- Mailing Fax
- (315) 359-2167
- Practice Street Address
- 1200 Driving Park Ave
- Practice City
- Newark
- Practice State
- NY
- Practice ZIP Code
- 14513
- Practice Country
- US
- Practice Phone
- (315) 359-2123
- Practice Fax
- (315) 359-2167
- Enumeration Date
- August 12, 2005
- Last Updated
- October 24, 2019
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Family Nurse Practitioner (363LF0000X), Family Nurse Practitioner (363LF0000X), Nurse Practitioner (363L00000X)
- Other Identifiers
- 500704675 (OR)