Provider Demographics
NPI:1588969810
Name:AMY BRENNER MD & ASSOCIATES, LLC
Entity type:Organization
Organization Name:AMY BRENNER MD & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:G
Authorized Official - Last Name:BRENNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-777-0787
Mailing Address - Street 1:7593 TYLERS PLACE BLVD
Mailing Address - Street 2:STE 104
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45067
Mailing Address - Country:US
Mailing Address - Phone:513-777-0787
Mailing Address - Fax:513-777-0525
Practice Address - Street 1:7593 TYLERS PLACE BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-6312
Practice Address - Country:US
Practice Address - Phone:513-777-0787
Practice Address - Fax:513-777-0525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-18
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty