Provider Demographics
NPI:1124297718
Name:BRABAND, JANE ANN (RD, CDN)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:ANN
Last Name:BRABAND
Suffix:
Gender:F
Credentials:RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3111 WINTON RD S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-2905
Mailing Address - Country:US
Mailing Address - Phone:585-214-1547
Mailing Address - Fax:585-214-1136
Practice Address - Street 1:3111 WINTON RD S
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-2905
Practice Address - Country:US
Practice Address - Phone:585-214-1547
Practice Address - Fax:585-214-1136
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001583-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered