Healthcare Provider Details

I. General information

NPI: 1154247476
Provider Name (Legal Business Name): ADRIAN BRERETON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2581 ATLANTIC AVE
BROOKLYN NY
11207-2412
US

IV. Provider business mailing address

23 MELRICK CT
WESTBURY NY
11590-2425
US

V. Phone/Fax

Practice location:
  • Phone: 929-238-4395
  • Fax:
Mailing address:
  • Phone: 929-238-4395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number128086
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: