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NPI Code Detail

MEDICARE: DR. BRUCE J. BRENER MD

MEDICARE: DR. BRUCE J. BRENER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician25MA02742400NJ
22086S0129XVascular Surgery Physician25MA02742400NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053317636
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRUCE J. BRENER MD
Provider Business Mailing Address
First Line : 200 S ORANGE AVE
Second Line :
City : LIVINGSTON
State : NJ
Zip : 07039-5817
Country : US
Telephone Number : 973-322-7233
Fax Number : 973-322-7499
Provider Business Practice Location Address
First Line : 200 S ORANGE AVE
Second Line :
City : LIVINGSTON
State : NJ
Zip : 07039-5817
Country : US
Telephone Number : 973-322-7233
Fax Number : 973-322-7499
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2005
Last Update Date : 03/13/2024

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