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NPI Code Detail

MEDICARE: DR. STEPHEN M BRENNER MD

MEDICARE:  DR. STEPHEN M BRENNER  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
1207R00000XInternal Medicine Physician090574-1NY
2207RG0100XGastroenterology Physician090574-1NY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00187514OTHERNYRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245234202
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHEN M BRENNER MD
Provider Business Mailing Address
First Line : 1 CHRISTIE PL # 407
Second Line :
City : SCARSDALE
State : NY
Zip : 10583-8302
Country : US
Telephone Number : 914-723-9113
Fax Number : 718-601-5642
Provider Business Practice Location Address
First Line : 1 CHRISTIE PLACE, #407
Second Line :
City : SCARSDALE
State : NY
Zip : 10583-0000
Country : US
Telephone Number : 914-723-9113
Fax Number : 718-601-5642
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2005
Last Update Date : 11/06/2012

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Directions to “ DR. STEPHEN M BRENNER MD” Practice Location

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