Brennan, Mark

Brennan, Mark is an individual health care provider with primary practice located at 30 Harrison St Ste 455, Johnson City NY 13790-2161. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Brennan, Mark can be contacted via phone (607) 763-8100.

Contact Information

Primary practice address
30 Harrison St Ste 455 Johnson City NY 13790-2161
Phone: (607) 763-8100
Fax: (607) 763-8048
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 217717 New York
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 217717 New York

Profile Details

NPI number 1174523443
LBN Legal business name Brennan, Mark
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2005
Last updated Sep 15th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174523443 NPPES
New York MEDICAID 02082319

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