Individual
MITCHELL J BREIDBART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
724 166TH ST 9A, WHITESTONE, NY 11357-2036
(718) 746-7704
Mailing address
724 166TH ST 9A, WHITESTONE, NY 11357-2036
(718) 746-7704
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N003703
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00869732
—
NY
Enumeration date
07/13/2005
Last updated
08/01/2016
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