1285662361 NPI number — DR. DAVID H BREEN MD

Table of content: DR. DAVID H BREEN MD (NPI 1285662361)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285662361 NPI number — DR. DAVID H BREEN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BREEN
Provider First Name:
DAVID
Provider Middle Name:
H
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285662361
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/25/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3889 NORTH RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GENESEO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14454
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-243-4000
Provider Business Mailing Address Fax Number:
585-243-4002

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
36 ELIZABETH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DANSVILLE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14437-1632
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-335-2030
Provider Business Practice Location Address Fax Number:
585-235-2035
Provider Enumeration Date:
06/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  122238 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 105882DL . This is a "PFC" identifier . This identifiers is of the category "OTHER".
  • Identifier: P010122238 . This is a "BC" identifier . This identifiers is of the category "OTHER".
  • Identifier: P020122238 . This is a "BLS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00892439 . This is a "MED" identifier . This identifiers is of the category "OTHER".
  • Identifier: 050607970 . This is a "CHRMSCO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 050607970 . This is a "CHVA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 33807 . This is a "UCH 1" identifier . This identifiers is of the category "OTHER".
  • Identifier: 35667B . This is a "MEDICARE OLD PTAN INDIVIDUAOL" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000526488003 . This is a "BLSW" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000526488003 . This is a "CMB" identifier . This identifiers is of the category "OTHER".
  • Identifier: 33807 . This is a "UHC 2" identifier . This identifiers is of the category "OTHER".
  • Identifier: 050607970 . This is a "CHSTW" identifier . This identifiers is of the category "OTHER".
  • Identifier: 050607970 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5265330 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000526488003 . This is a "HNN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 050607970 . This is a "CHEMP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 050607970 . This is a "CHUNI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 67043 . This is a "FHN" identifier . This identifiers is of the category "OTHER".
  • Identifier: P010122238 . This is a "BCO" identifier . This identifiers is of the category "OTHER".




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