Provider Demographics
NPI:1104324698
Name:ANDERSEN, BRITTANY LYNN
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LYNN
Last Name:ANDERSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 E 33RD ST FL 12
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5362
Mailing Address - Country:US
Mailing Address - Phone:212-283-3000
Mailing Address - Fax:
Practice Address - Street 1:300 PANTIGO PL
Practice Address - Street 2:
Practice Address - City:EAST HAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11937-2684
Practice Address - Country:US
Practice Address - Phone:631-538-0920
Practice Address - Fax:631-527-7387
Is Sole Proprietor?:No
Enumeration Date:2018-01-30
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021789363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant