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NPI Code Detail

MEDICARE: BRESHAY WOODS

MEDICARE:   BRESHAY  WOODS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianSP035272PA

General Provider Information

NPI Number : 1003768672
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRESHAY WOODS
Provider Business Mailing Address
First Line : 4510 FRANKFORD AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19124-3602
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4510 FRANKFORD AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19124-3602
Country : US
Telephone Number : 443-453-4795
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2026
Last Update Date : 02/13/2026

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Directions to “ BRESHAY WOODS ” Practice Location

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