Provider Demographics
NPI:1063842409
Name:BREUER, CAROLYN J (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:J
Last Name:BREUER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 MORIAH LN
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-3709
Mailing Address - Country:US
Mailing Address - Phone:845-368-0328
Mailing Address - Fax:
Practice Address - Street 1:65 CHAPEL ST
Practice Address - Street 2:
Practice Address - City:GARNERVILLE
Practice Address - State:NY
Practice Address - Zip Code:10923-1238
Practice Address - Country:US
Practice Address - Phone:845-942-3213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-21
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013128103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical