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General NPI Number Information
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NPI Number | 1578517645
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Entity Type | Organization
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Legal Business Name | WILLIAM F. BRENNAN D.O.,P.A.
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Dates
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Enumeration Date | 05/21/2006
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Last Update Date | 09/01/2007
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Provider Practice Location Address
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Address Line | 145 MAIN ST
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City | MANTUA
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State | NJ
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Zip | 08051-1011
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Country | US
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Telephone | 856-468-5184
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Fax | 856-468-7370
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Provider Business Mailing Address
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Address Line | 145 MAIN ST
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City | MANTUA
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State | NJ
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Zip | 08051-1011
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Country | US
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Telephone | 856-468-5184
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Fax | 856-468-7370
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM FREDERICK BRENNAN
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Credential | D.O.
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Telephone | 856-468-5184
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MB03184700
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License Number State | NJ
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