Healthcare Provider Details

I. General information

NPI: 1396160313
Provider Name (Legal Business Name): CHRISTOPHER BREEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2014
Last Update Date: 06/23/2021
Certification Date: 06/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 TUCK ST
LEBANON PA
17042-7477
US

IV. Provider business mailing address

3421 CONCORD RD
YORK PA
17402-9001
US

V. Phone/Fax

Practice location:
  • Phone: 717-272-8173
  • Fax: 717-272-4029
Mailing address:
  • Phone: 717-851-1405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberOS018738
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: