Provider Demographics
NPI:1215282249
Name:POSTELNECK FAIX, BRENDA ANN
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:ANN
Last Name:POSTELNECK FAIX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 THROGGMORTON AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-1429
Mailing Address - Country:US
Mailing Address - Phone:347-268-4583
Mailing Address - Fax:
Practice Address - Street 1:1160 THROGGMORTON AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-1429
Practice Address - Country:US
Practice Address - Phone:347-268-4583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist