Provider Demographics
NPI:1447944020
Name:BRAINARD, MALGORZATA (CARDIAC SONOGRAPHER)
Entity type:Individual
Prefix:
First Name:MALGORZATA
Middle Name:
Last Name:BRAINARD
Suffix:
Gender:F
Credentials:CARDIAC SONOGRAPHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 MILLBURY DR
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-3815
Mailing Address - Country:US
Mailing Address - Phone:440-552-6145
Mailing Address - Fax:
Practice Address - Street 1:1045 MILLBURY DR
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-3815
Practice Address - Country:US
Practice Address - Phone:440-552-6145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach