Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0204X | Pediatric Emergency Doctor | D0069551 | MD |
Y | 2080P0204X | Pediatric Emergency Doctor | MD036283 | DC |
NPI | 1295790715 |
---|---|
Provider Name | Kristen A Breslin |
First Address | Bethesda, MD 20814-2801 |
Second Address | Washington, DC 20010-2916 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2006 |
Last Update Date | 10/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0199371 | (05) | MA |