Individual
BRENNON TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1522 UNIONPORT RD APT 2F, BRONX, NY 10462-7840
(347) 554-4974
Mailing address
1522 UNIONPORT RD APT 2F, BRONX, NY 10462-7840
(347) 554-4974
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
23.006765
CT
Other
Enumeration date
06/22/2023
Last updated
09/13/2024
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