Brenner, Gary Jay
Brenner, Gary Jay is an individual health care provider with primary practice located at 55 Fruit St Cln 3, Boston MA 02114-2621. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Brenner, Gary Jay can be contacted via phone (617) 726-8810.Contact Information
Primary practice address
55 Fruit St Cln 3
Boston MA 02114-2621
Phone: (617) 726-8810
Fax: (617) 724-3632
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | 160622 | Massachusetts |
Profile Details
| NPI number | 1447240627 |
|---|---|
| LBN Legal business name | Brenner, Gary Jay |
| Credentials | MD PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 27th, 2005 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447240627 | NPPES |
| Massachusetts | MEDICAID | 0121681 | |
| Massachusetts | Other | I60622 | |
| Massachusetts | Other | J22624 |
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