Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 42586 | NJ |
NPI | 1003811043 |
---|---|
Provider Name | Dr. Michael Jerome Brien |
First Address | South Orange, NJ 07079-1331 |
Second Address | West Orange, NJ 07052-5597 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 02/11/2021 |