Provider Demographics
NPI:1184423261
Name:ROONEY, BRENDAN LEO
Entity type:Individual
Prefix:
First Name:BRENDAN
Middle Name:LEO
Last Name:ROONEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 KELLOGG DR
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-1409
Mailing Address - Country:US
Mailing Address - Phone:203-604-7157
Mailing Address - Fax:
Practice Address - Street 1:370 BASSETT RD
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-4201
Practice Address - Country:US
Practice Address - Phone:203-604-7157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program