Provider Demographics
NPI:1922986959
Name:WEPPNER, BRENNAN R
Entity type:Individual
Prefix:
First Name:BRENNAN
Middle Name:R
Last Name:WEPPNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 CHEVAL RD
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-2134
Mailing Address - Country:US
Mailing Address - Phone:716-480-2244
Mailing Address - Fax:
Practice Address - Street 1:8 S AVENUE B
Practice Address - Street 2:
Practice Address - City:ENDWELL
Practice Address - State:NY
Practice Address - Zip Code:13760-5714
Practice Address - Country:US
Practice Address - Phone:607-754-3414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-26
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY507997146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic