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:
Health care specialties
| Specialty | Code | License # | 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 11 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 | 1174523443 | NPPES |
| New York | MEDICAID | 02082319 |
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