Provider Demographics
NPI:1639139355
Name:BRENNER, HILLARY BETH (DPM)
Entity Type:Individual
Prefix:MRS
First Name:HILLARY
Middle Name:BETH
Last Name:BRENNER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 BROADWAY
Mailing Address - Street 2:SUITE #1000 10TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038
Mailing Address - Country:US
Mailing Address - Phone:212-227-9655
Mailing Address - Fax:212-227-8829
Practice Address - Street 1:133 E 58TH ST
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:NY
Practice Address - Zip Code:10022-1162
Practice Address - Country:US
Practice Address - Phone:212-753-3520
Practice Address - Fax:212-753-3521
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-25
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006084213ES0131X
NY#006084213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV04725Medicare UPIN