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NPI Code Detail

MEDICARE: BRUCE T BRENNAN MD

MEDICARE: BRUCE T BRENNAN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician022798CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013927797
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRUCE T BRENNAN MD
Provider Business Mailing Address
First Line : 22 WESTFIELD AVE
Second Line :
City : ANSONIA
State : CT
Zip : 06401-1158
Country : US
Telephone Number : 203-734-7100
Fax Number : 203-734-3392
Provider Business Practice Location Address
First Line : 22 WESTFIELD AVE
Second Line :
City : ANSONIA
State : CT
Zip : 06401-1158
Country : US
Telephone Number : 203-734-7100
Fax Number : 203-734-3392
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2006
Last Update Date : 08/16/2010

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Directions to “ BRUCE T BRENNAN MD” Practice Location

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