Provider Demographics
NPI:1497992937
Name:BRESLAU, CAROL MORGAN (MED)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:MORGAN
Last Name:BRESLAU
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 MILFORD ST
Mailing Address - Street 2:STE 101
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-6966
Mailing Address - Country:US
Mailing Address - Phone:410-742-1567
Mailing Address - Fax:410-742-1906
Practice Address - Street 1:4 AURORA ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-1902
Practice Address - Country:US
Practice Address - Phone:410-221-0333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-20
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00549237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter