Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 031496 | NY |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 50-031496 | NY |
NPI | 1073683330 |
---|---|
Provider Name | Dr. Andrew S Breiman |
First Address | Yonkers, NY 10710 |
Second Address | Yonkers, NY 10710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 15/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00678024-ETIN-AJ19 | (05) | NY |
DODO11 | (02) | NY |