Provider Demographics
NPI:1114288529
Name:BRESLIN, PETER B (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:B
Last Name:BRESLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5540 FALMOUTH STREET
Mailing Address - Street 2:SUITE 103
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230
Mailing Address - Country:US
Mailing Address - Phone:804-495-8661
Mailing Address - Fax:804-486-9819
Practice Address - Street 1:5540 FALMOUTH ST STE 103
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-1800
Practice Address - Country:US
Practice Address - Phone:804-495-8661
Practice Address - Fax:804-486-9819
Is Sole Proprietor?:No
Enumeration Date:2012-06-01
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01012567202084A0401X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine