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NPI Code Detail

MEDICARE: DR. TRACY M. BRENNER M.D.

MEDICARE: DR. TRACY M. BRENNER M.D.
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
1207RR0500XRheumatology PhysicianME166610FL

General Provider Information

NPI Number : 1053598896
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TRACY M. BRENNER M.D.
Provider Business Mailing Address
First Line : 900 COTTAGE GROVE RD
Second Line :
City : BLOOMFIELD
State : CT
Zip : 06002-2920
Country : US
Telephone Number : 800-997-1654
Fax Number :
Provider Business Practice Location Address
First Line : 900 COTTAGE GROVE RD
Second Line :
City : BLOOMFIELD
State : CT
Zip : 06002-2920
Country : US
Telephone Number : 800-997-1654
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2008
Last Update Date : 03/18/2026

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