Provider Demographics
NPI:1982862066
Name:BREA, ANTHONY F (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:F
Last Name:BREA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 COTTAGE GROVE RD
Mailing Address - Street 2:STE D230
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-3080
Mailing Address - Country:US
Mailing Address - Phone:860-243-0708
Mailing Address - Fax:860-243-0708
Practice Address - Street 1:701 COTTAGE GROVE RD
Practice Address - Street 2:STE. D230
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-3080
Practice Address - Country:US
Practice Address - Phone:860-243-0708
Practice Address - Fax:860-243-0708
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1497111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor