Provider Demographics
NPI:1407237811
Name:BRESLAUER, CORI (MD)
Entity Type:Individual
Prefix:
First Name:CORI
Middle Name:
Last Name:BRESLAUER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3428 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-4664
Mailing Address - Country:US
Mailing Address - Phone:520-603-7489
Mailing Address - Fax:
Practice Address - Street 1:PATHOLOGY AND LAB MEDICINE
Practice Address - Street 2:BBB CB 7525
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7525
Practice Address - Country:US
Practice Address - Phone:984-974-9132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ209586207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology