Most Relevant Information
Provider Data
| NPI Number: | 1003302183 |
| Provider Name: | BREYNN ENTWISTLE PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 10858311-1206 |
Most Important Dates
| Enumeration Date: | 07/02/2018 |
| Last Updated: | 10/21/2024 |
Provider Practice Location
479 COUNTY ROAD 520 STE B101
MARLBORO
NJ
077461089
Practice Location Phone/Fax
| Phone: | 7328565999 |
| Fax: |
Provider Mailing Location
1000 14TH AVE
BELMAR
NJ
077192809
Provider Mailing Phone/Fax
| Phone: | 7326158951 |
| Fax: |