| Timothy Brannan, Md, Llc | |
|
377 Jersey Ave Suite 220 Jersey City NJ 07302-4393 | |
| (201) 309-2380 | |
| (201) 309-2381 |
| Full Name | Timothy Brannan, Md, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 377 Jersey Ave, Jersey City, New Jersey |
| Authorized Official Name and Position | Timothy Brannan (OWNER) |
| Authorized Official Contact | 2013092380 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Timothy Brannan, Md, Llc Po Box 808 Teaneck NJ 07666-0808 Ph: (201) 309-2380 | Timothy Brannan, Md, Llc 377 Jersey Ave Suite 220 Jersey City NJ 07302-4393 Ph: (201) 309-2380 |
| NPI Number | 1992094965 |
|---|---|
| Provider Enumeration Date | 03/30/2011 |
| Last Update Date | 03/30/2011 |
| Medicare PECOS PAC ID | 8628237591 |
|---|---|
| Medicare Enrollment ID | O20120313000172 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992094965 | NPI | - | NPPES |
| 7262906 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 25MA06506400 (New Jersey) | Primary |
| Provider Name | Timothy S Brannan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1619946431 PECOS PAC ID: 0345409215 Enrollment ID: I20120313000221 |
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