Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | 25MA10730700 | NJ |
N | 2086S0102X | Surgical Critical Care | MD451674 | PA |
N | 2086S0127X | Trauma Surgeon | MD451674 | PA |
NPI | 1427295344 |
---|---|
Provider Name | Dr. Brendan Mccracken |
First Address | Marlton, NJ 08053-4197 |
Second Address | Haddon Heights, NJ 08035-1938 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2009 |
Last Update Date | 19/10/2020 |