| Jerry M Brennan Phd Inc | |
|
651 Kaumakani St Honolulu HI 96825-1827 | |
| (808) 538-0343 | |
| Not Available |
| Full Name | Jerry M Brennan Phd Inc |
|---|---|
| Speciality | Psychologist |
| Location | 651 Kaumakani St, Honolulu, Hawaii |
| Authorized Official Name and Position | Jerry M Brennan (PRESIDENT) |
| Authorized Official Contact | 8085380343 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jerry M Brennan Phd Inc 651 Kaumakani St Honolulu HI 96825-1827 Ph: (808) 538-0343 | Jerry M Brennan Phd Inc 651 Kaumakani St Honolulu HI 96825-1827 Ph: (808) 538-0343 |
| NPI Number | 1558602839 |
|---|---|
| Provider Enumeration Date | 03/11/2013 |
| Last Update Date | 03/11/2013 |
| Medicare PECOS PAC ID | 6709022098 |
|---|---|
| Medicare Enrollment ID | O20130410000517 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558602839 | NPI | - | NPPES |
| 01269301 | Medicaid | HI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY-277 (Hawaii) | Primary |
| Provider Name | Jerry M Brennan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063517324 PECOS PAC ID: 4183640022 Enrollment ID: I20051019001055 |
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