Provider Demographics
NPI:1821403536
Name:BRESLIN, ROBERT (RPH)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:BRESLIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 ROBERTS CT
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02881-1792
Mailing Address - Country:US
Mailing Address - Phone:401-742-2098
Mailing Address - Fax:
Practice Address - Street 1:25 ROBERTS CT
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:RI
Practice Address - Zip Code:02881-1792
Practice Address - Country:US
Practice Address - Phone:401-742-2098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA22282183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist