Individual
DANIELLE BRENZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
11 PARKE PLACE BLVD, SUITE A, SEWELL, NJ 08080-2664
(856) 218-4848
Mailing address
1001 BRIGGS RD, 210, MOUNT LAUREL, NJ 08054-4100
(856) 231-4774
(856) 231-9699
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MB70308
NJ
207Q00000X
Family Medicine Physician
Primary
25MB07030800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2138629000
AMERIHEALTH
NJ
01
—
222137644
CHAMPUS/TRICARE
NJ
05
—
8920401
—
NJ
01
—
90000011100
AMERICHOICE
NJ
Enumeration date
07/19/2006
Last updated
02/08/2010
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