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General NPI Number Information
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NPI Number | 1043285158
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Entity Type | Individual
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Provider Name | BETH BREAKSTONE M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 701 N BROADWAY PHELPS PATHOLOGY
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City | SLEEPY HOLLOW
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State | NY
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Zip | 10591-1020
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Country | US
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Telephone | 845-562-7995
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Fax |
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Provider Business Mailing Address
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Address Line | 10 LOUISE DR
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City | NEW WINDSOR
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State | NY
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Zip | 12553-7712
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Country | US
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Telephone | 845-562-7995
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 161002
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License Number State | NY
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