Allison Laura Breen

Individual provider Active NPI Licensed Practical Nurse · Newark, NY

NPI 1154838191 · NPPES record last updated Dec 29, 2017

Key facts

NPI
1154838191
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
320240 (NY)
Practice address
123 South Ave
Newark, NY 14513-1938
Phone
(315) 573-9597
NPI assigned
Dec 29, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
320240NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 320240 NY Yes

Addresses

Primary practice location

123 South Ave
Newark, NY 14513-1938

Mailing address

123 South Ave
Newark, NY 14513-1938

Other providers in Newark, NY

All providers in Newark, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.