MEDICARE: DR. DEBRA L BREITMAN DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	N004366	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285644344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBRA L BREITMAN DPM

Provider Business Mailing Address
First Line	:	135 ROCKAWAY TPKE STE 107
Second Line	:
City	:	LAWRENCE
State	:	NY
Zip	:	11559-1023
Country	:	US
Telephone Number	:	516-239-7400
Fax Number	:	516-400-9039

Provider Business Practice Location Address
First Line	:	135 ROCKAWAY TPKE STE 107
Second Line	:
City	:	LAWRENCE
State	:	NY
Zip	:	11559-1023
Country	:	US
Telephone Number	:	516-239-7400
Fax Number	:	516-400-9039

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	06/05/2019

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