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NPI Code Detail

MEDICARE: MICHAELA BRENNAN

MEDICARE:   MICHAELA  BRENNAN
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
1363L00000XNurse PractitionerAG02260048NJ

General Provider Information

NPI Number : 1740124643
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAELA BRENNAN
Provider Business Mailing Address
First Line : 50 HAMILTON AVE
Second Line :
City : BERKELEY HEIGHTS
State : NJ
Zip : 07922-1869
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 50 HAMILTON AVE
Second Line :
City : BERKELEY HEIGHTS
State : NJ
Zip : 07922-1869
Country : US
Telephone Number : 908-400-1234
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2026
Last Update Date : 04/20/2026

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Directions to “ MICHAELA BRENNAN ” Practice Location

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