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Individual

DR. STEPHEN M BRENNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 CHRISTIE PLACE, #407, SCARSDALE, NY 10583-0000
(914) 723-9113
(718) 601-5642
Mailing address
1 CHRISTIE PL # 407, SCARSDALE, NY 10583-8302
(914) 723-9113
(718) 601-5642

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
090574-1
NY
207RG0100X
Gastroenterology Physician
Primary
090574-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001434719
NY
01
P00187514
RAILROAD MEDICARE
NY
Enumeration date
06/08/2005
Last updated
11/06/2012
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