Provider Demographics
NPI:1245331842
Name:BREEN, CHRISTOPHER MICHAEL (RPA-C)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:MICHAEL
Last Name:BREEN
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Gender:M
Credentials:RPA-C
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Mailing Address - Street 1:1300 FRANKLIN AVE
Mailing Address - Street 2:SUITE UL3A
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-1886
Mailing Address - Country:US
Mailing Address - Phone:516-663-2224
Mailing Address - Fax:516-663-8124
Practice Address - Street 1:1300 FRANKLIN AVE
Practice Address - Street 2:SUITE UL3A
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-1886
Practice Address - Country:US
Practice Address - Phone:516-663-2224
Practice Address - Fax:516-663-8124
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2021-02-26
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Provider Licenses
StateLicense IDTaxonomies
NY008931363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1245331842Medicare UPIN