Individual
LOIS MARGARET BRENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
83 EAST AVENUE, 302, NORWAK, CT 06857
(203) 853-1919
Mailing address
12 E 86TH ST, 1230, NEW YORK, NY 10028-0506
(212) 734-1551
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
011227-1
NY
Other
Enumeration date
10/20/2006
Last updated
07/08/2007
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