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NPI Code Detail

MEDICARE: MARC A. BRENNER

MEDICARE: MARC A. BRENNER
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
1213ES0103XFoot & Ankle Surgery PodiatristNY
2213E00000XPodiatristNY

General Provider Information

NPI Number : 1427352723
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARC A. BRENNER
Provider Business Mailing Address
First Line : 1899 ROCKAWAY PARKWAY
Second Line :
City : BROOKLYN
State : NY
Zip : 11236-5307
Country : US
Telephone Number : 718-251-1122
Fax Number : 718-251-1856
Provider Business Practice Location Address
First Line : 1899 ROCKAWAY PKWY
Second Line :
City : BROOKLYN
State : NY
Zip : 11236-5307
Country : US
Telephone Number : 718-251-1122
Fax Number : 718-251-1856
Authorized Official
Title or Position : OWNER
Name : MARC A BRENNER
Credential :
Telephone Number : 718-251-1122
Provider Enumeration Date : 12/29/2010
Last Update Date : 12/29/2010

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