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General NPI Number Information
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NPI Number | 1639178890
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Entity Type | Organization
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Legal Business Name | DR. SIDNEY BRENNER ASSOCIATES
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2175 KNORR ST
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City | PHILADELPHIA
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State | PA
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Zip | 19149-2307
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Country | US
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Telephone | 215-624-2491
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Fax | 215-624-4259
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Provider Business Mailing Address
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Address Line | 2175 KNORR ST
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City | PHILADELPHIA
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State | PA
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Zip | 19149-2307
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Country | US
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Telephone | 215-624-2491
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Fax | 215-624-4259
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Authorized Official
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Title or Position | PARTNER
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Name | DR. RICHARD PAUL BRENNER
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Credential | DO
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Telephone | 215-624-2491
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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 |
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License Number State | PA
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