Provider Demographics
NPI:1952036386
Name:BREUSS, ALEXEY DANTES
Entity Type:Individual
Prefix:
First Name:ALEXEY
Middle Name:DANTES
Last Name:BREUSS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 GREYSTONE LN APT 4
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-5123
Mailing Address - Country:US
Mailing Address - Phone:718-775-5533
Mailing Address - Fax:
Practice Address - Street 1:81 LAKE AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14608-1410
Practice Address - Country:US
Practice Address - Phone:585-922-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral