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NPI Code Detail

MEDICARE: DR. GERALD I BRESNER DPM

MEDICARE: DR. GERALD I BRESNER DPM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213E00000XPodiatrist857NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
25019850001OTHERNJDME

General Provider Information

NPI Number : 1063432193
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GERALD I BRESNER DPM
Provider Business Mailing Address
First Line : 75 BLOOMFIELD AVE
Second Line : SUITE 106
City : DENVILLE
State : NJ
Zip : 07834-2735
Country : US
Telephone Number : 973-627-7090
Fax Number : 973-625-7767
Provider Business Practice Location Address
First Line : 75 BLOOMFIELD AVE
Second Line : SUITE 106
City : DENVILLE
State : NJ
Zip : 07834-2735
Country : US
Telephone Number : 973-627-7090
Fax Number : 973-625-7767
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2006
Last Update Date : 04/17/2008

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