Provider Demographics
NPI:1487973715
Name:BRESLIN, JOHN JOSEPH (RNFA)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:JOSEPH
Last Name:BRESLIN
Suffix:
Gender:M
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 C.R. 94
Mailing Address - Street 2:
Mailing Address - City:HANKINS
Mailing Address - State:NY
Mailing Address - Zip Code:12741
Mailing Address - Country:US
Mailing Address - Phone:845-887-4053
Mailing Address - Fax:
Practice Address - Street 1:317COUNTY ROAD 94
Practice Address - Street 2:
Practice Address - City:HANKINS
Practice Address - State:NY
Practice Address - Zip Code:12741
Practice Address - Country:US
Practice Address - Phone:845-887-4053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY573471163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE