Provider Demographics
NPI:1811129463
Name:BREEN, JEANNE DEMARS (MD)
Entity type:Individual
Prefix:
First Name:JEANNE
Middle Name:DEMARS
Last Name:BREEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 HIDDEN COVE RD
Mailing Address - Street 2:
Mailing Address - City:OLD SAYBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06475-1620
Mailing Address - Country:US
Mailing Address - Phone:860-399-6541
Mailing Address - Fax:
Practice Address - Street 1:229 HIDDEN COVE RD
Practice Address - Street 2:
Practice Address - City:OLD SAYBROOK
Practice Address - State:CT
Practice Address - Zip Code:06475-1620
Practice Address - Country:US
Practice Address - Phone:860-399-6541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-17
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT045767207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease