| John Brennan, MD | |
|
700 E Broad St, Hazleton, PA 18201-6835 | |
| (570) 501-4156 | |
| Not Available |
| Full Name | John Brennan |
|---|---|
| Gender | Male |
| Speciality | Pathology - Anatomic Pathology & Clinical Pathology |
| Location | 700 E Broad St, Hazleton, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710966304 | NPI | - | NPPES |
| 0019740530003 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ZC0500X | Pathology - Cytopathology | MD058575L (Pennsylvania) | Secondary |
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | MD058474L (Pennsylvania) | Primary |
| Entity Name | St Lukes Physician Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700984622 PECOS PAC ID: 6709798333 Enrollment ID: O20040226000062 |
| Entity Name | Delta Medix Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396701876 PECOS PAC ID: 0648162636 Enrollment ID: O20040325001062 |
| Entity Name | Pathology Associates Of Ne Pa Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528022142 PECOS PAC ID: 3274516208 Enrollment ID: O20040610001409 |
| Entity Name | Lehigh Gastroenterology Associates |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619961018 PECOS PAC ID: 0547247447 Enrollment ID: O20040630000028 |
| Mailing Address | Practice Location Address |
|---|---|
| John Brennan, MD 511 Red Ridge Rd, Zion Grove, PA 17985-9677 Ph: (570) 384-0716 | John Brennan, MD 700 E Broad St, Hazleton, PA 18201-6835 Ph: (570) 501-4156 |
Mary Frances Pascucci, DO Pathology Medicare: Not Enrolled in Medicare Practice Location: 148 N Sherman Ct, Hazleton, PA 18201 Phone: 570-454-6301 Fax: 570-454-6815 |