Individual
BREANNE MARIE PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
111 MALTESE DR, MIDDLETOWN, NY 10940-2141
(845) 342-4774
Mailing address
111 MALTESE DR, MIDDLETOWN, NY 10940-2141
(845) 342-4774
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
028248
NY
363AM0700X
Medical Physician Assistant
25MP00228600
NJ
363AM0700X
Medical Physician Assistant
MA053102
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028248
LICENSE
NY
Enumeration date
10/05/2007
Last updated
09/07/2022
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