Provider Demographics
NPI:1902177975
Name:BREEN, ABIGAIL (RN)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:BREEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 SUNSET BLVD.
Mailing Address - Street 2:
Mailing Address - City:COXSACKIE
Mailing Address - State:NY
Mailing Address - Zip Code:12051
Mailing Address - Country:US
Mailing Address - Phone:518-731-1805
Mailing Address - Fax:518-731-1807
Practice Address - Street 1:24 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:COXSACKIE
Practice Address - State:NY
Practice Address - Zip Code:12051-1132
Practice Address - Country:US
Practice Address - Phone:518-731-1805
Practice Address - Fax:518-731-1807
Is Sole Proprietor?:No
Enumeration Date:2012-01-23
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307345-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool