Johnson, Colleen Breen

Johnson, Colleen Breen is an individual health care provider with primary practice located at 11 Medical Dr , Port Jefferson Station NY 11776-1589. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Johnson, Colleen Breen can be contacted via phone (631) 509-6066.

Contact Information

Primary practice address
11 Medical Dr Port Jefferson Station NY 11776-1589
Phone: (631) 509-6066
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 020304 New York
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 020304-1 New York

Profile Details

NPI number 1215235429
LBN Legal business name Johnson, Colleen Breen
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 11th, 2011
Last updated Sep 27th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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