Individual
DR. BARRY STEVEN BRENNER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2175 KNORR ST, PHILADELPHIA, PA 19149-2307
(215) 624-2491
(215) 624-4259
Mailing address
455 TINA DR, SOUTHAMPTON, PA 18966-3643
(215) 322-2882
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD021739E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0058419000
INDEPENDENCE BLUE CROSS
PA
01
—
0268562004
CIGNA HEALTHCARE
PA
01
—
19356
AENTAUSHEALTHCARE
PA
Enumeration date
07/17/2005
Last updated
07/08/2007
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