Provider Demographics
NPI:1497935738
Name:BREED, SABRINA (PHD)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:BREED
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 1:100 W 89TH ST APT 4M
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1934
Mailing Address - Country:US
Mailing Address - Phone:917-207-9612
Mailing Address - Fax:
Practice Address - Street 1:210 W 70TH ST APT 201
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-4363
Practice Address - Country:US
Practice Address - Phone:917-207-9612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-03
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015001 1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYVM5901Medicare PIN