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General NPI Number Information
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NPI Number | 1962604645
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Entity Type | Individual
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Provider Name | JAN L BRESLOW M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1230 YORK AVE
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City | NEW YORK
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State | NY
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Zip | 10021-6307
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Country | US
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Telephone | 212-327-7704
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Fax |
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Provider Business Mailing Address
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Address Line | 10 HORSEGUARD LN
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City | SCARSDALE
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State | NY
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Zip | 10583-2311
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Country | US
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Telephone | 914-472-8793
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Fax |
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 123561-1
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License Number State | NY
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