Provider Demographics
NPI:1588696728
Name:BRETAN, AMY FAITH (MD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:FAITH
Last Name:BRETAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:200 RARITAN COMMONS RTE 31 NORTH
Mailing Address - Street 2:SUITE 105
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-1154
Mailing Address - Country:US
Mailing Address - Phone:908-782-5100
Mailing Address - Fax:908-782-0290
Practice Address - Street 1:200 RARITAN COMMONS RTE 31 NORTH
Practice Address - Street 2:SUITE 105
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-1154
Practice Address - Country:US
Practice Address - Phone:908-782-5100
Practice Address - Fax:908-782-0290
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2020-08-21
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA07861500207QA0505X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA07861500OtherMEDICAL LICENSE