Provider Demographics
NPI:1073911590
Name:BREEN, ANDREA (NP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:BREEN
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:3 CROSSING BLVD
Mailing Address - Street 2:STE 1
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-4172
Mailing Address - Country:US
Mailing Address - Phone:518-262-6696
Mailing Address - Fax:518-262-6770
Practice Address - Street 1:43 NEW SCOTLAND AVE
Practice Address - Street 2:MC 7
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3412
Practice Address - Country:US
Practice Address - Phone:518-262-6696
Practice Address - Fax:518-262-6770
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-16
Last Update Date:2019-09-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY306956363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04058971Medicaid
NYP01494474OtherRAILROAD MEDICARE
NYP01494474OtherRAILROAD MEDICARE