MR. CHRISTIAN MICHAEL BRENNER II (NPI# 1811214638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811214638 |
| Entity Type | Individual |
| Full Name | MR. CHRISTIAN MICHAEL BRENNER II |
| Credential | PA-C, ATC |
| Practice Address |
201 Mullica Hill Rd Glassboro NJ 08028-1700 |
| Practice Telephone | 8562564000 |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2012-12-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
25MT00153100 | NJ | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407456346 | Christian Brenner | Social Worker | 177 Prince St, New York, NY 10012-2946 | 2020-10-29 |
| Street Address |
201 MULLICA HILL RD |
| City | GLASSBORO |
| State | NJ |
| Zip Code | 08028-1700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538151121 | Chuck Whedon | Rehabilitation Practitioner | 201 Mullica Hill Rd, Rowan University Athletic Training, Glassboro, NJ 08028-1700 | 2005-08-18 |
| 1518597186 | Cindy Marie Goodrow | Nurse Practitioner | 201 Mullica Hill Rd, Glassboro, NJ 08028-1700 | 2020-01-22 |
| 1669935169 | Nicole M Thompson | Specialist/Technologist | 201 Mullica Hill Rd, Glassboro, NJ 08028-1700 | 2019-04-11 |
| 1073016127 | Helen E Polak | Psychologist | 201 Mullica Hill Rd, Glassboro, NJ 08028-1700 | 2018-03-15 |
| 1780122424 | Douglas Mann | Prevention Professional | 201 Mullica Hill Rd, Rowan University, Glassboro, NJ 08028-1700 | 2017-02-02 |
| 1003282153 | Rowan Wellness Center - Family Medicine | Family Medicine | 201 Mullica Hill Rd, Winans Hall, Glassboro, NJ 08028-1700 | 2015-08-12 |
| 1609242775 | Rowan Wellness Center - Behavioral Health | Psychiatry & Neurology | 201 Mullica Hill Rd, Winans Hall, Glassboro, NJ 08028-1700 | 2015-08-12 |
| 1700269503 | Rowan University - Dept. of Psychology | Psychologist | 201 Mullica Hill Rd, Robinson Hall, Glassboro, NJ 08028-1700 | 2015-06-30 |
| 1710385265 | Thomas J. Dinzeo | Psychologist | 201 Mullica Hill Rd, Glassboro, NJ 08028-1700 | 2014-12-16 |
| 1588074173 | Charmaine M Cirino Thomas | Nurse Practitioner | 201 Mullica Hill Rd, Glassboro, NJ 08028-1700 | 2014-05-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508320581 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1328 East Boulevard, Glassboro, NJ 08028 | 2019-01-24 |
| 1427512599 | Elwyn New Jersey | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 210 Pennsylvania Avenue, Glassboro, NJ 08028 | 2019-01-23 |
| 1639641210 | Seth Frost | Counselor | 2 Delsea Dr S., Glassboro, NJ 08028 | 2018-12-20 |
| 1083195788 | Strong Tower Social Services, Inc | Clinic/Center | 341 Fish Pond Road, Glassboro, NJ 08028 | 2018-08-22 |
| 1023506730 | Tri-county Support Coordination LLC | Case Management | 275 E High St, Ste S364, Glassboro, NJ 08028 | 2018-04-27 |
| 1558872721 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 32 Reading Street, Apt. #2, Glassboro, NJ 08028 | 2017-10-16 |
| 1073023545 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 960 North Main Street, Glassboro, NJ 08028 | 2017-10-10 |
| 1366978645 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 685 Aura Rd, Glassboro, NJ 08028 | 2017-05-05 |
| 1831623594 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3 Potsdam Court, Glassboro, NJ 08028 | 2017-04-19 |
| 1003340761 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 113 Stoneham Drive, Glassboro, NJ 08028 | 2017-04-19 |
| Find all providers in zip 08028 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062463 | Erica Josephine Lobuglio | Physician Assistant | 733 N Beers St Ste U3, Holmdel, NJ 07733-1513 | 2020-08-04 |
| 1407471493 | Angelice Grasso | Physician Assistant | 3 Holly Ln, Garfield, NJ 07026-3565 | 2020-06-15 |
| 1063036358 | Jaina Marie Lumkong | Physician Assistant | 905 Allwood Rd Ste 204, Clifton, NJ 07012-1946 | 2020-06-02 |
| 1740804384 | Allison Sy Tan | Physician Assistant | 10 Bahr Cir, Verona, NJ 07044-3200 | 2020-05-29 |
| 1114560851 | Brian Paul Leonhardt | Physician Assistant | 1113 Hospital Drive Professional Building East, Suite 100, Willingboro, NJ 08046 | 2019-10-25 |
| 1740830413 | Atara Hagler | Physician Assistant | 1500 Pleasant Valley Way Ste 101, West Orange, NJ 07052-2956 | 2019-09-16 |
| 1568943058 | Ekaterina M Rezvin | Physician Assistant | 80 Woodland Park Dr, Tenafly, NJ 07670-3028 | 2018-08-23 |
| 1225550353 | Kristen Cordiello | Physician Assistant | 1610 Route 88 Ste 203, Brick, NJ 08724-3018 | 2017-07-11 |
| 1710408232 | Angela Marie Freedman | Physician Assistant | 1 Riverview Plaza Multi Disciplinary Cancer Center, Red Bank, NJ 07701 | 2017-07-06 |
| 1063932259 | Matthew Gabriel | Physician Assistant | 25 Prospect Avernue, 2nd Floor, Hackensack, NJ 07601 | 2017-06-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.