Provider Demographics
NPI:1528668977
Name:BRESLIN, JOHN J III
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:BRESLIN
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 ELLEN CT
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08332-4720
Mailing Address - Country:US
Mailing Address - Phone:856-371-6266
Mailing Address - Fax:
Practice Address - Street 1:431 ELLEN CT
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332-4720
Practice Address - Country:US
Practice Address - Phone:856-371-6266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01869500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist