Individual
BRUCE JOHN BRENNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1003 WALNUT ST, ELMIRA, NY 14901-1007
(607) 732-5646
(607) 732-0373
Mailing address
1003 WALNUT ST, ELMIRA, NY 14901-1007
(607) 732-5646
(607) 732-0373
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
380322
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1457010910
NPI
—
Enumeration date
05/01/2022
Last updated
05/01/2022
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