MEDICARE: JACK L BRENNER MD PC

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
1	207R00000X	Internal Medicine Physician	1064781	NY
2	207RG0100X	Gastroenterology Physician	1064781	NY

General Provider Information

NPI Number	:	1417268046
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JACK L BRENNER MD PC

Provider Business Mailing Address
First Line	:	1974 MAPLE HILL ST
Second Line	:	SUITE 6
City	:	YORKTOWN HTS
State	:	NY
Zip	:	10598-4190
Country	:	US
Telephone Number	:	914-962-5596
Fax Number	:	914-962-5919

Provider Business Practice Location Address
First Line	:	1974 MAPLE HILL ST
Second Line	:	SUITE 6
City	:	YORKTOWN HTS
State	:	NY
Zip	:	10598-4190
Country	:	US
Telephone Number	:	914-962-5596
Fax Number	:	914-962-5919

Authorized Official
Title or Position	:	MEDICAL DOCTOR
Name	:	DR. JACK L BRENNER
Credential	:	M.D.
Telephone Number	:	914-962-5596

Provider Enumeration Date	:	06/29/2010
Last Update Date	:	01/10/2018

Similar Medicare Providers

1760485601 — DR. JEFFREY MARTIN GINSBERG D.M.D.
Practice Location Address:

1974 MAPLE HILL ST
YORKTOWN HEIGHTS, NY
10598-4190

Practice Phone: 914-245-1670
Practice Fax: 914-245-1576

1376527564 — ELIZABETH DARZYNKIEWICZ M.D.
Practice Location Address:

1974 MAPLE HILL ST
YORKTOWN HEIGHTS, NY
10598-4190

Practice Phone: 914-962-3815
Practice Fax: 914-962-3821

1235407792 — ELZBIETA DARZYNKIEWICZ MD PC
Practice Location Address:

1974 MAPLE HILL ST
YORKTOWN HEIGHTS, NY
10598-4190

Practice Phone: 914-962-3815
Practice Fax: 914-962-3821

1306366083 — DR. STACI BRUNELL DMD
Practice Location Address:

1974 MAPLE HILL ST # A
YORKTOWN HEIGHTS, NY
10598-4190

Practice Phone: 914-245-1670
Practice Fax:

1174248017 — GOLDEN CARES LLC
Practice Location Address:

6001 LANDERHAVEN DR STE A2
MAYFIELD HTS, OH
44124-4190

Practice Phone: 440-459-1233
Practice Fax:

1093420259 — AGAINST ALL O.D.D.S. RESIDENTIAL SERVICES LLC
Practice Location Address:

6001 LANDERHAVEN DR # A2
MAYFIELD HTS, OH
44124-4190

Practice Phone: 216-688-5312
Practice Fax:

Directions to “JACK L BRENNER MD PC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.