Individual
TARA BRESLIN
Active
Individual
TARA BRESLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
000593
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005930121
CONNECTICARE
CT
01
—
290000593CT03
BLUE CROSS BLUE SHIELD
CT
Enumeration date
08/22/2006
Last updated
09/17/2019
Update your record
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