Provider Demographics
NPI:1598741027
Name:BREA, ALLISON (RPH)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:BREA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3950 CARR 176
Mailing Address - Street 2:APTO 64
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6624
Mailing Address - Country:US
Mailing Address - Phone:787-760-1280
Mailing Address - Fax:787-283-3673
Practice Address - Street 1:CARR 176 ESQ SAN CLAUDIO
Practice Address - Street 2:SAN GENARO 352
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-760-1280
Practice Address - Fax:787-283-3673
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5119183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist