Provider Demographics
NPI:1750263992
Name:BRENNAN, OLIVIA ANN (AUD)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:ANN
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11782-3104
Mailing Address - Country:US
Mailing Address - Phone:631-750-6377
Mailing Address - Fax:518-504-6661
Practice Address - Street 1:58 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11782-3104
Practice Address - Country:US
Practice Address - Phone:631-750-6377
Practice Address - Fax:518-504-6661
Is Sole Proprietor?:No
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3492387231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist