Individual
LAWRENCE BRENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3004 146TH ST, FLUSHING, NY 11354-2324
(347) 610-1807
Mailing address
25 SHERWOOD LN, CEDARHURST, NY 11516-2618
(516) 840-3478
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
1746580
NY
Other
Enumeration date
07/13/2019
Last updated
07/13/2019
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