Provider Demographics
NPI:1720085715
Name:BRENDLINGER, JEFFREY C (DO)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:C
Last Name:BRENDLINGER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1587 POTTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464
Mailing Address - Country:US
Mailing Address - Phone:610-326-5822
Mailing Address - Fax:
Practice Address - Street 1:40 BERKSHIRE CT
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1224
Practice Address - Country:US
Practice Address - Phone:610-374-7400
Practice Address - Fax:610-374-4252
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2010-08-12
Deactivation Date:2005-08-31
Deactivation Code:
Reactivation Date:2007-01-05
Provider Licenses
StateLicense IDTaxonomies
PAOS011076L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001840149Medicaid
PA001840149Medicaid
H35091Medicare UPIN