MEDICARE: LAUREN E BRENNAN PA-C

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
1	363AM0700X	Medical Physician Assistant	MA062528	PA

General Provider Information

NPI Number	:	1598389355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN E BRENNAN PA-C

Provider Business Mailing Address
First Line	:	191 PRESIDENTIAL BLVD PH 24
Second Line	:
City	:	BALA CYNWYD
State	:	PA
Zip	:	19004-1213
Country	:	US
Telephone Number	:	215-774-1306
Fax Number	:	866-489-3869

Provider Business Practice Location Address
First Line	:	191 PRESIDENTIAL BLVD PH 24
Second Line	:
City	:	BALA CYNWYD
State	:	PA
Zip	:	19004-1213
Country	:	US
Telephone Number	:	215-774-1306
Fax Number	:	866-489-3869

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2020
Last Update Date	:	06/23/2026

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Directions to “ LAUREN E BRENNAN PA-C” Practice Location

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