Individual
STEPHEN BRENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
129 YORK ST, NEW HAVEN, CT 06511-5608
(203) 789-8888
Mailing address
2989 DIXWELL AVE, HAMDEN, CT 06518-3501
(203) 248-3013
(203) 248-2878
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
17408
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010017408CT03
BLUE CROSS BLUE SHIELD
CT
01
—
1051333
AETNA
CT
01
—
757491
CONNECTICARE
CT
01
—
NHP118
OXFORD
CT
Enumeration date
07/20/2005
Last updated
01/24/2013
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