Provider Demographics
NPI:1073683330
Name:BREIMAN, ANDREW S (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:S
Last Name:BREIMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 MARKET STREET
Mailing Address - Street 2:SUITE 377
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710
Mailing Address - Country:US
Mailing Address - Phone:914-779-5606
Mailing Address - Fax:914-968-2474
Practice Address - Street 1:73 MARKET STREET
Practice Address - Street 2:SUITE 377
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710
Practice Address - Country:US
Practice Address - Phone:914-779-5606
Practice Address - Fax:914-968-2474
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0314961223S0112X
NY50-0314961223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00678024-ETIN-AJ19Medicaid
NYDODO11Medicare UPIN