Provider Demographics
NPI:1033647060
Name:BRESHINSKY, LISA
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:BRESHINSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 DANIEL BRAY HWY
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08559-1819
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2200 DANIEL BRAY HWY
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:NJ
Practice Address - Zip Code:08559-1819
Practice Address - Country:US
Practice Address - Phone:908-361-4442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-04
Last Update Date:2017-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor