Provider Demographics
NPI:1750362695
Name:BRENER, DARA GAIL (MD)
Entity type:Individual
Prefix:DR
First Name:DARA
Middle Name:GAIL
Last Name:BRENER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PARTNERS IN PRIMARY CARE
Mailing Address - Street 2:45 RESEARCH WAY SUITE 208A
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733
Mailing Address - Country:US
Mailing Address - Phone:631-675-2125
Mailing Address - Fax:631-675-2628
Practice Address - Street 1:267 E MAIN ST BLDG C
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2847
Practice Address - Country:US
Practice Address - Phone:631-418-8069
Practice Address - Fax:631-656-0470
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2022-04-28
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Provider Licenses
StateLicense IDTaxonomies
NY236587207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY137SX1Medicare ID - Type Unspecified
I37303Medicare UPIN