Brenner, Robert Maurice
Brenner, Robert Maurice is an sole proprietor health care provider with primary practice located at 70 Park Ave W , Mansfield OH 44902-1624. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Brenner, Robert Maurice can be contacted via phone (419) 525-1207.Contact Information
Primary practice address
70 Park Ave W
Mansfield OH 44902-1624
Phone: (419) 525-1207
Fax: (419) 525-0030
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 3398 | Ohio |
Profile Details
| NPI number | 1689629206 |
|---|---|
| LBN Legal business name | Brenner, Robert Maurice |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 23rd, 2006 |
| Last updated | Jun 23rd, 2011 - about 13 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 | 1689629206 | NPPES |
| Ohio | MEDICAID | 0406742 |
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