Provider Demographics
NPI:1316241680
Name:BRENNAN, JENNIFER MARIE (WOMEN'S HEALTH N P)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:MARIE
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:WOMEN'S HEALTH N P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 E 44TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-4008
Mailing Address - Country:US
Mailing Address - Phone:646-725-9500
Mailing Address - Fax:
Practice Address - Street 1:178 CHURCH ST
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-4165
Practice Address - Country:US
Practice Address - Phone:845-471-1530
Practice Address - Fax:845-471-1519
Is Sole Proprietor?:No
Enumeration Date:2010-12-30
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6162181163W00000X
NYF4210121363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse