Individual
BREEANN DOHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
90 HENRY ST, INWOOD, NY 11096-2335
(718) 327-3401
Mailing address
295 42ND ST, LINDENHURST, NY 11757-2752
(631) 805-7658
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
841816728
NY
Other
Enumeration date
05/04/2015
Last updated
05/04/2015
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