Provider Demographics
NPI:1134187511
Name:BRENT, NANCY BERANBAUM (MD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:BERANBAUM
Last Name:BRENT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5734 SOLWAY ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-1204
Mailing Address - Country:US
Mailing Address - Phone:412-421-0897
Mailing Address - Fax:412-421-0897
Practice Address - Street 1:4070 BEECHWOOD BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-2679
Practice Address - Country:US
Practice Address - Phone:412-521-6511
Practice Address - Fax:412-521-6512
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD023944E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PABR1055451Medicaid
PABR1055451Medicaid
PAE69166Medicare UPIN