Healthcare Provider Details

I. General information

NPI: 1235217183
Provider Name (Legal Business Name): ANNE T. BRENKERT MS,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 E 17TH ST # 78
BROOKLYN NY
11229-1258
US

IV. Provider business mailing address

10 LAMPLIGHTER LN APT 4A
MASSAPEQUA NY
11758-5617
US

V. Phone/Fax

Practice location:
  • Phone: 718-375-1200
  • Fax:
Mailing address:
  • Phone: 516-797-5558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number001755-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: