Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Colleen Breen Johnson, PA-C

Individual provider Physician Assistant · NPI 1215235429

Colleen Breen Johnson, PA-C is a Physician Assistant in Port Jefferson Station, New York. Licensed in New York. Registered with an NPI since 2011.

Licensed in
NY
In the registry since
2011
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

11 Medical Dr
Port Jefferson Station, NY 11776-1589
Phone: (631) 509-6066
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 020304-1 (NY)
Physician Assistant Taxonomy 363A00000X · Licence 020304 (NY)

Record details

NPI number1215235429
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 11, 2011
Last updated in NPPESSeptember 27, 2018

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