Individual
JOHN BRENNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 E BROAD ST, HAZLETON, PA 18201-6835
(570) 501-4156
Mailing address
511 RED RIDGE RD, ZION GROVE, PA 17985-9677
(570) 384-0716
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
MD058575L
PA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD058474L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019740530003
—
PA
Enumeration date
01/11/2006
Last updated
04/05/2018
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