Provider Demographics
NPI:1851394001
Name:BRECK, H. JANE (MD)
Entity Type:Individual
Prefix:
First Name:H.
Middle Name:JANE
Last Name:BRECK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:H.
Other - Middle Name:JANE
Other - Last Name:MIKULIAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11279 PERRY HWY
Mailing Address - Street 2:STE 450
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9303
Mailing Address - Country:US
Mailing Address - Phone:724-933-1100
Mailing Address - Fax:724-933-1160
Practice Address - Street 1:5608 WILKINS AVE
Practice Address - Street 2:STE 202
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1212
Practice Address - Country:US
Practice Address - Phone:412-422-3590
Practice Address - Fax:412-422-3759
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD010551E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006603240004Medicaid
PAD69992Medicare UPIN