Healthcare Provider Details

I. General information

NPI: 1982211306
Provider Name (Legal Business Name): MICAELA BRESLER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2020
Last Update Date: 09/29/2020
Certification Date: 09/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 S 2ND ST
HAMILTON OH
45011-2811
US

IV. Provider business mailing address

3572 CENTURION DR
CINCINNATI OH
45211-1800
US

V. Phone/Fax

Practice location:
  • Phone: 513-454-1111
  • Fax:
Mailing address:
  • Phone: 513-824-2447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208U00000X
TaxonomyClinical Pharmacology Physician
License Number03337183
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: