| Earl Barry Breeland, MD | |
|
79-01 Broadway, Room A1-9, Elmhurst, NY 11373-1329 | |
| (718) 334-4952 | |
| (718) 334-4815 |
| Full Name | Earl Barry Breeland |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Location | 79-01 Broadway, Elmhurst, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932136306 | NPI | - | NPPES |
| 00828735 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 156005 (New York) | Primary |
| Entity Name | Icahn School Of Medicine At Mount Sinai |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609120674 PECOS PAC ID: 8224282926 Enrollment ID: O20130205000439 |
| Entity Name | Physician Affiliate Group Of New York Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013375526 PECOS PAC ID: 4688098833 Enrollment ID: O20200721001270 |
| Mailing Address | Practice Location Address |
|---|---|
| Earl Barry Breeland, MD 79-01 Broadway, Room A1-9, Elmhurst, NY 11373-1329 Ph: (718) 334-4952 | Earl Barry Breeland, MD 79-01 Broadway, Room A1-9, Elmhurst, NY 11373-1329 Ph: (718) 334-4952 |
Carl M. Pellman, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 7901 Broadway, Room A1-9, Elmhurst, NY 11373 Phone: 718-334-4952 Fax: 718-334-4815 | |
Roberto E Granato, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 4046 75th St, Elmhurst, NY 11373 Phone: 718-335-1437 Fax: 718-899-1846 | |
Dr. Krishna Jhaveri, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 6008 Junction Blvd, Elmhurst, NY 11373 Phone: 718-271-2800 Fax: 718-271-7455 |