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Individual

ANNE E BRENA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
353 BLAIR PARK RD, WILLISTON, VT 05495-7530
(802) 847-1470
Mailing address
353 BLAIR PARK RD, WILLISTON, VT 05495-7530
(802) 847-1470

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
042.0012529
VT
207R00000X
Internal Medicine Physician
223593
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000499880001
BS OF NENY LEGACY
NY
05
002242639
NY
01
116300
MVP LEGACY
NY
01
7797529
AETNA LEGACY
NY
01
P010223593
EXCELLUS LEGACY
NY
01
P52210
EMPIRE BC/BS LEGACY
NY
Enumeration date
10/04/2006
Last updated
10/16/2012
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