Dr. Jack Leon Brenner
Internist Gastroenterologist
1974 Maple Hill Street Suite 6
Yorktown Heights
, New York 10598
Dr. Jack Leon Brenner
Internist Gastroenterologist
1974 Maple Hill Street Suite 6
Yorktown Heights
, New York 10598
(914) 962-5919
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About
Features
Specialties
- Internist
- Gastroenterologist
Languages spoken
- English
Location
First Address
- Dr. Jack Leon Brenner
- 1974 Maple Hill St Suite 6
- Yorktown Heights, NY
- Zip : 10598-4190
- Fax : (914) 962-5919
- Phone : (914) 962-5596
Second Address
- Dr. Jack Leon Brenner
- 1974 Maple Hill Street Suite 6
- Yorktown Heights, NY
- Zip : 10598
- Fax : (914) 962-5919
- Phone : (914) 962-5596
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207R00000X | Internist | 106478 | NY |
| N | 111NI0900X | Internist | 106478 | NY |
| Y | 207RG0100X | Gastroenterologist | 106478 | NY |
National Provider Identifier
| NPI | 1033287347 |
|---|---|
| Provider Name | Dr. Jack Leon Brenner |
| First Address | Yorktown Heights, NY 10598-4190 |
| Second Address | Yorktown Heights, NY 10598 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/12/2006 |
| Last Update Date | 19/09/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| C11424 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.