Provider Demographics
NPI:1366843526
Name:BRESLAU, JANET
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:BRESLAU
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 1:94 SWEETWATER AVENUE
Mailing Address - Street 2:UNIT 2
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-1106
Mailing Address - Country:US
Mailing Address - Phone:617-538-1397
Mailing Address - Fax:
Practice Address - Street 1:94 SWEETWATER AVENUE
Practice Address - Street 2:UNIT 2
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-1106
Practice Address - Country:US
Practice Address - Phone:617-538-1397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3694225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist