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General NPI Number Information
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NPI Number | 1063432193
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Entity Type | Individual
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Provider Name | GERALD I BRESNER DPM
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Gender | Male
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 04/17/2008
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Provider Practice Location Address
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Address Line | 75 BLOOMFIELD AVE SUITE 106
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City | DENVILLE
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State | NJ
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Zip | 07834-2735
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Country | US
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Telephone | 973-627-7090
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Fax | 973-625-7767
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Provider Business Mailing Address
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Address Line | 75 BLOOMFIELD AVE SUITE 106
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City | DENVILLE
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State | NJ
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Zip | 07834-2735
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Country | US
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Telephone | 973-627-7090
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Fax | 973-625-7767
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 857
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License Number State | NJ
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