Individual
KELSEANNE BREDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 HAVEN AVE, 25D, NEW YORK, NY 10032
(407) 697-6254
Mailing address
100 HAVEN AVE, 25D, NEW YORK, NY 10032-2645
(407) 697-6254
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
709514
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402383
NY
Other
Enumeration date
08/31/2016
Last updated
07/30/2018
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