Provider Demographics
NPI:1710131180
Name:FRESE, BRIAN S (OTR/L, CHT)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:S
Last Name:FRESE
Suffix:
Gender:M
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1465 ROUTE 31
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08801-3129
Mailing Address - Country:US
Mailing Address - Phone:908-735-6866
Mailing Address - Fax:
Practice Address - Street 1:1465 ROUTE 31
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:NJ
Practice Address - Zip Code:08801-3129
Practice Address - Country:US
Practice Address - Phone:908-735-6866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-11
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00127300225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand