Healthcare Provider Details

I. General information

NPI: 1841279346
Provider Name (Legal Business Name): KENNETH ROBERT BREIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2006
Last Update Date: 01/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 QUEENSWOOD DR
YORK PA
17403-4254
US

IV. Provider business mailing address

1945 QUEENSWOOD DR
YORK PA
17403-4254
US

V. Phone/Fax

Practice location:
  • Phone: 717-846-6900
  • Fax: 717-854-9728
Mailing address:
  • Phone: 717-846-6900
  • Fax: 717-854-9728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD029282E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: