Healthcare Provider Details

I. General information

NPI: 1922935006
Provider Name (Legal Business Name): BRENDAN JOHN EGAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 WISCONSIN AVE NW STE 200
WASHINGTON DC
20007
US

IV. Provider business mailing address

1700 HARVARD ST NW APT 206
WASHINGTON DC
20009-2912
US

V. Phone/Fax

Practice location:
  • Phone: 202-944-5400
  • Fax: 855-771-6849
Mailing address:
  • Phone: 847-732-4852
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: