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General NPI Number Information
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NPI Number | 1023259074
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Entity Type | Organization
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Legal Business Name | BRESLOW MEDICAL PC
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Dates
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Enumeration Date | 03/19/2009
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Last Update Date | 03/19/2009
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Provider Practice Location Address
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Address Line | 2754 CONEY ISLAND AVE STE 56
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City | BROOKLYN
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State | NY
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Zip | 11235-5016
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Country | US
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Telephone | 347-834-5069
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Fax | 877-219-1596
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Provider Business Mailing Address
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Address Line | 2754 CONEY ISLAND AVE STE 56
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City | BROOKLYN
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State | NY
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Zip | 11235-5016
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Country | US
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Telephone | 347-834-5069
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Fax | 877-219-1596
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Authorized Official
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Title or Position | PRESIDENT
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Name | GARY D BRESLOW
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Credential | MD
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Telephone | 347-834-5069
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 228436
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License Number State | NY
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