Provider Demographics
NPI:1639535594
Name:BRUNNER, PATRICK (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:
Last Name:BRUNNER
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 1:5 E 98TH ST
Mailing Address - Street 2:FL 5
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6501
Mailing Address - Country:US
Mailing Address - Phone:917-244-1085
Mailing Address - Fax:
Practice Address - Street 1:1230 YORK AVE
Practice Address - Street 2:THE ROCKEFELLER UNIVERSITY HOSPITAL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6307
Practice Address - Country:US
Practice Address - Phone:212-327-8091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-07
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY290252-01207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty