MELISSA ANN BRENNAN, PA - NPI NUMBER 1093968844

Summary

Provider Name: MELISSA ANN BRENNAN, PA

NPI Number: 1093968844

Clasification: Physician Assistant (363A00000X)

Address:
12 CENTER ST
SUITE 1
FREDONIA, NY
ZIP 14063

Phone Number: (716) 679-2233



Detailed Information

Melissa Ann Brennan, PA is a physician assistant in Fredonia, NY. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. The assigned NPI number for this provider is 1093968844 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business address is:

12 CENTER ST
SUITE 1
FREDONIA, NY
ZIP 14063-716
Phone: (716) 679-2233
Fax: (716) 679-9698

The enumeration date for this NPI number is 10/24/2008 and was last updated on 10/24/2008.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 363A00000X Physician Assistant 012934 NY Yes

NPI Record

No. Field Name Field Value
1 NPI 1093968844
2 Entity Type Code 1
3 Provider Last Name Legal Name BRENNAN
4 Provider First Name MELISSA
5 Provider Middle Name ANN
6 Provider Credential Text PA
7 Provider First Line Business Practice Location Address 12 CENTER ST
8 Provider Second Line Business Practice Location Address SUITE 1
9 Provider Business Practice Location Address City Name FREDONIA
10 Provider Business Practice Location Address State Name NY
11 Provider Business Practice Location Address Postal Code 140631716
12 Provider Business Practice Location Address Country Code If outside U S US
13 Provider Business Practice Location Address Telephone Number 7166792233
14 Provider Business Practice Location Address Fax Number 7166799698
15 Provider Enumeration Date 10/24/2008
16 Last Update Date 10/24/2008
17 Provider Gender Code F
18 Healthcare Provider Taxonomy Code 1 363A00000X
19 Provider License Number 1 012934
20 Provider License Number State Code 1 NY
21 Healthcare Provider Primary Taxonomy Switch 1 Y
22 Is Sole Proprietor N

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This page was last updated on: 8/12/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.