Provider Demographics
NPI:1114927159
Name:BRESALIER, HOWARD (DO)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:
Last Name:BRESALIER
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 WHITE PLAINS RD FL 4
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5187
Mailing Address - Country:US
Mailing Address - Phone:914-333-5801
Mailing Address - Fax:
Practice Address - Street 1:239 HURFFVILLE CROSSKEYS RD STE 265
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-4008
Practice Address - Country:US
Practice Address - Phone:856-576-5745
Practice Address - Fax:856-519-5410
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB06552400207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7264909Medicaid
NJ7264909Medicaid
F95721Medicare UPIN