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NPI 1497842405

NPI 1497842405 : DR. FRED J BRESLER : WATERTOWN, NY

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General NPI Number Information
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    NPI Number           |    1497842405
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    Entity Type          |    Individual 
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    Provider Name        |    DR. FRED J BRESLER
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/10/2006
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    Last Update Date     |    04/08/2010
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Provider Practice Location Address
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    Address Line         |    1246 ARSENAL ST 
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    City                 |    WATERTOWN
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    State                |    NY
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    Zip                  |    13601
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    Country              |    US
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    Telephone            |    315-782-2600
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    Fax                  |    315-782-3010
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Provider Business Mailing Address
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    Address Line         |    1246 ARSENAL ST 
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    City                 |    WATERTOWN
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    State                |    NY
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    Zip                  |    13601
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    Country              |    US
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    Telephone            |    315-782-2600
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    Fax                  |    315-782-3010
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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        |    152W00000X
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    Taxonomy Name        |    Optometrist
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    License Number       |    TUV003336
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    License Number State |    NY
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