Individual
JAY MILLER BRENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2342
(315) 464-4363
(315) 464-8690
Mailing address
750 E ADAMS ST, SYRACUSE, NY 13210-2342
(315) 464-4363
(315) 464-8690
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
243870
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02878100
—
NY
Enumeration date
05/09/2007
Last updated
01/22/2009
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