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Individual

LEWIS BRESLAU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
AUD

Contact information

Practice address
176 N VILLAGE AVE, ROCKVILLE CENTRE, NY 11570-3800
(516) 678-1804
(516) 678-0445
Mailing address
176 N VILLAGE AVE, ROCKVILLE CENTRE, NY 11570-3800
(516) 221-2390
(516) 221-2395

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
0009661
NY
237600000X
Audiologist-Hearing Aid Fitter
0009661
NY
237600000X
Audiologist-Hearing Aid Fitter
14000002408
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0036041
GHI
NY
01
100189235701
AMERICHOICE
NY
01
112920413
TAX ID
NY
01
1892357
UNITED HEALTHCARE
NY
01
19697P
HIP
NY
01
500021
AETNA NUMBER
NY
01
8461006002
CIGNA
01
DS155
OXFORD
NY
Enumeration date
05/15/2006
Last updated
11/20/2008
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