Provider Demographics
NPI:1376906891
Name:KIERNAN, BRENDAN (MD)
Entity Type:Individual
Prefix:
First Name:BRENDAN
Middle Name:
Last Name:KIERNAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 INDUSTRIAL RD STE 5
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-3736
Mailing Address - Country:US
Mailing Address - Phone:508-473-1480
Mailing Address - Fax:
Practice Address - Street 1:98 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-3009
Practice Address - Country:US
Practice Address - Phone:084-787-1355
Practice Address - Fax:508-473-7198
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA172782207XS0114X
MA292210207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery