Provider Demographics
NPI:1437310570
Name:CARNEY, BRENDAN TIMOTHY (MOAM, JAS)
Entity Type:Individual
Prefix:MR
First Name:BRENDAN
Middle Name:TIMOTHY
Last Name:CARNEY
Suffix:
Gender:M
Credentials:MOAM, JAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 FLORAL ST APT 4
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02461-1544
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:114 FLORAL ST APT 4
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02461-1544
Practice Address - Country:US
Practice Address - Phone:617-584-1450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist