MEDICARE: TIMOTHY S BRANNAN 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
1	2084N0400X	Neurology Physician	MA65064	NJ

Other Identifiers

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

General Provider Information

NPI Number	:	1619946431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY S BRANNAN MD

Provider Business Mailing Address
First Line	:	377 JERSEY AVE
Second Line	:	SUITE 220
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-4393
Country	:	US
Telephone Number	:	201-309-2380
Fax Number	:	201-309-2381

Provider Business Practice Location Address
First Line	:	377 JERSEY AVE
Second Line	:	SUITE 220
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-4393
Country	:	US
Telephone Number	:	201-309-2380
Fax Number	:	201-309-2381

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2006
Last Update Date	:	04/18/2012

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Directions to “ TIMOTHY S BRANNAN MD” Practice Location

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