Provider Demographics
NPI:1326135674
Name:BRENNAN, EILEEN ELIZABETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:ELIZABETH
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 DE KOVEN CT
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-1708
Mailing Address - Country:US
Mailing Address - Phone:718-434-2935
Mailing Address - Fax:718-982-2159
Practice Address - Street 1:26 DE KOVEN CT
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-1708
Practice Address - Country:US
Practice Address - Phone:718-434-2935
Practice Address - Fax:718-982-2159
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000602-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist