Individual
COLLEEN BREIVOGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
165 LANDER ST, NEWBURGH, NY 12550-4534
(845) 674-4953
Mailing address
165 LANDER ST, NEWBURGH, NY 12550-4534
(845) 674-4953
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
328489
NY
Other
Enumeration date
10/21/2021
Last updated
10/21/2021
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