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General NPI Number Information
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NPI Number | 1558447789
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Entity Type | Individual
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Provider Name | TERRIE JEAN BRENNAN NP
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Gender | Female
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 285 SILLS RD BLDG 5-6 SUITE A
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City | EAST PATCHOGUE
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State | NY
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Zip | 11772-4869
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Country | US
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Telephone | 631-475-9300
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Fax | 631-475-6648
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Provider Business Mailing Address
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Address Line | 160 SOUTHERN BLVD
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City | NESCONSET
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State | NY
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Zip | 11767
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Country | US
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Telephone | 631-484-0861
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Fax | 631-361-8525
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F303006
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License Number State | NY
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