Basic Information
Provider Information
NPI: 1861726721
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BRESILIEN
FirstName: JOSUE
MiddleName:  
NamePrefix: MR.
NameSuffix:  
Credential: RRT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 800 POLY PL
Address2: RESPIRATORY CARE ROOM 13-120
City: BROOKLYN
State: NY
PostalCode: 112097104
CountryCode: US
TelephoneNumber: 7188366600
FaxNumber:  
Practice Location
Address1: 800 POLY PL
Address2: RESPIRATORY CARE ROOM 13-120
City: BROOKLYN
State: NY
PostalCode: 112097104
CountryCode: US
TelephoneNumber: 7188366600
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/25/2009
LastUpdateDate: 09/25/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2279G1100X005032NYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGeneral Care

No ID Information.


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