Provider Demographics
NPI:1235346958
Name:BREEN, PHILIP CORNELIUS (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:CORNELIUS
Last Name:BREEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:525 FULTON DR
Mailing Address - Street 2:
Mailing Address - City:MC CONNELLSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17233-8061
Mailing Address - Country:US
Mailing Address - Phone:717-485-3850
Mailing Address - Fax:717-485-3725
Practice Address - Street 1:109 RAYLOC DR
Practice Address - Street 2:
Practice Address - City:HANCOCK
Practice Address - State:MD
Practice Address - Zip Code:21750-1518
Practice Address - Country:US
Practice Address - Phone:301-678-5187
Practice Address - Fax:301-678-5797
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2013-04-17
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Provider Licenses
StateLicense IDTaxonomies
PAMD016955E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC30853Medicare UPIN