Individual
MARK BRENNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
30 HARRISON ST, STE 455, JOHNSON CITY, NY 13790-2161
(607) 763-8100
(607) 763-8048
Mailing address
346 GRAND AVE, UNITED MEDICAL ASSOCIATES, PC, JOHNSON CITY, NY 13790-2558
(607) 763-8100
(607) 729-8866
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
217717
NY
2086S0129X
Vascular Surgery Physician
Primary
217717
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02082319
—
NY
Enumeration date
07/28/2005
Last updated
09/15/2014
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