Healthcare Provider Details

I. General information

NPI: 1134515786
Provider Name (Legal Business Name): ELIEZER BRECHER D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2015
Last Update Date: 12/07/2025
Certification Date: 12/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3457 BOSTON RD
BRONX NY
10469-2508
US

IV. Provider business mailing address

35 WILLOW POND LN
HEWLETT NY
11557-2202
US

V. Phone/Fax

Practice location:
  • Phone: 347-590-9910
  • Fax:
Mailing address:
  • Phone: 516-984-7475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number060581
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: