Provider Demographics
NPI:1497780746
Name:BRETON, JAMES W (RPAC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:W
Last Name:BRETON
Suffix:
Gender:M
Credentials:RPAC
Other - Prefix:
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Mailing Address - Street 1:30 HAGEN DR
Mailing Address - Street 2:STE 220
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2658
Mailing Address - Country:US
Mailing Address - Phone:585-295-5314
Mailing Address - Fax:585-248-2112
Practice Address - Street 1:30 HAGEN DR
Practice Address - Street 2:STE 220
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2658
Practice Address - Country:US
Practice Address - Phone:585-295-5314
Practice Address - Fax:585-248-2112
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2023-07-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY7458363A00000X
0074581363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG0185663590OtherPREFERRED CARE
NYP019007458OtherBLUE CROSS BLUE SHIELD
P24585Medicare UPIN