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General NPI Number Information
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NPI Number | 1689820474
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Entity Type | Individual
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Provider Name | TIMOTHY KOEHLER BRENNAN MD
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Gender | Male
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Dates
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Enumeration Date | 08/12/2008
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Last Update Date | 06/19/2018
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Provider Practice Location Address
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Address Line | 1000 10TH AVE FL 8
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City | NEW YORK
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State | NY
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Zip | 10019
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Country | US
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Telephone | 212-523-8943
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Fax | 212-523-8057
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Provider Business Mailing Address
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Address Line | 1400 IRVING ST NW #312
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City | WASHINGTON
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State | DC
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Zip | 20010-2850
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Country | US
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Telephone |
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Fax |
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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 | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | 260958
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License Number State | NY
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