Provider Demographics
NPI:1326260589
Name:BRENNER, ARNOLD (CSW)
Entity Type:Individual
Prefix:MR
First Name:ARNOLD
Middle Name:
Last Name:BRENNER
Suffix:
Gender:M
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PLAZA STREET
Mailing Address - Street 2:1D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217
Mailing Address - Country:US
Mailing Address - Phone:718-783-3720
Mailing Address - Fax:718-783-3720
Practice Address - Street 1:1 PLAZA STREET
Practice Address - Street 2:1D
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217
Practice Address - Country:US
Practice Address - Phone:718-783-3720
Practice Address - Fax:718-783-3720
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR017657102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst