Provider Demographics
NPI:1194162628
Name:GARRETT, BRENDAN R (PA-C)
Entity type:Individual
Prefix:
First Name:BRENDAN
Middle Name:R
Last Name:GARRETT
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
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Mailing Address - Street 1:2150 HARRISBURG PIKE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:717-327-2962
Mailing Address - Fax:717-358-0803
Practice Address - Street 1:775 NORMAN DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7497
Practice Address - Country:US
Practice Address - Phone:717-274-5500
Practice Address - Fax:717-274-5500
Is Sole Proprietor?:No
Enumeration Date:2013-05-23
Last Update Date:2017-01-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA056133363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA502330FLTMedicare PIN