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Individual
LISA BRESLOW
Active
Individual
LISA BRESLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
032.0133896
VT
207Q00000X
Family Medicine Physician
2020-00363
NC
207Q00000X
Family Medicine Physician
25MB10740100
NJ
207Q00000X
Family Medicine Physician
302800
NY
207Q00000X
Family Medicine Physician
5101025286
MI
207Q00000X
Family Medicine Physician
Primary
OS018188
PA
207Q00000X
Family Medicine Physician
S5130
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031466770001
—
PA
Enumeration date
10/08/2008
Last updated
03/06/2020
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