Individual
DMITRIY BRENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
200 PERRINE RD STE 220, OLD BRIDGE, NJ 08857-2836
(201) 753-8862
(201) 408-5278
Mailing address
15 ENGLE ST STE 102, ENGLEWOOD, NJ 07631-2920
(201) 753-8862
(551) 245-8822
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00735100
NJ
Other
Enumeration date
09/23/2022
Last updated
09/23/2022
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