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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447240627 NPPES
Massachusetts MEDICAID 0121681
Massachusetts Other I60622
Massachusetts Other J22624

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