Provider Demographics
NPI:1699146480
Name:KANE, BRENDAN (DPM)
Entity type:Individual
Prefix:DR
First Name:BRENDAN
Middle Name:
Last Name:KANE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17425 OCEAN ONE PLZ UNIT 1
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1924
Mailing Address - Country:US
Mailing Address - Phone:302-297-8431
Mailing Address - Fax:
Practice Address - Street 1:17425 OCEAN ONE PLZ UNIT 1
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1924
Practice Address - Country:US
Practice Address - Phone:302-297-8431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-19
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPO-0024676213ES0103X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery