Organization
JACK L BRENNER MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK L BRENNER M.D. (MEDICAL DOCTOR)
(914) 962-5596
Entity
Organization
Contact information
Practice address
1974 MAPLE HILL ST, SUITE 6, YORKTOWN HTS, NY 10598-4190
(914) 962-5596
(914) 962-5919
Mailing address
1974 MAPLE HILL ST, SUITE 6, YORKTOWN HTS, NY 10598-4190
(914) 962-5596
(914) 962-5919
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
1064781
NY
207RG0100X
Gastroenterology Physician
Primary
1064781
NY
Other
Enumeration date
06/29/2010
Last updated
01/10/2018
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