Healthcare Provider Details

I. General information

NPI: 1326260589
Provider Name (Legal Business Name): ARNOLD BRENNER CSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PLAZA STREET 1D
BROOKLYN NY
11217
US

IV. Provider business mailing address

1 PLAZA STREET 1D
BROOKLYN NY
11217
US

V. Phone/Fax

Practice location:
  • Phone: 718-783-3720
  • Fax: 718-783-3720
Mailing address:
  • Phone: 718-783-3720
  • Fax: 718-783-3720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License NumberR017657
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: