| Doctor Name: | BRENDAN PATRICK TEEHAN |
| NPI Number: | 1083988992 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D.04 |
| License Number: | MD:1743E |
| Business Practice Address: | 377 Wyldhaven Rd Bryn Mawr, PA - 190101241 |
| Business Phone Number: | 6105270216 |
| Business Fax Number: | 6105270216 |
| Mailing Address: | 377 Wyldhaven Rd, BRYN MAWR |
| State: | PA |
| Postal Code: | 190101241 |
| Phone Number: | 6105270216 |
| Fax Number: | 6105270216 |
| NPI Enumeration Date: | 02/24/2012 |
| NPI Last Update Date: | 02/24/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QC1500X |
| License Number: | MD:1743E |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |