Provider Demographics
NPI:1750090189
Name:BRESNITZ, EDDY ARMIN (MD)
Entity type:Individual
Prefix:
First Name:EDDY
Middle Name:ARMIN
Last Name:BRESNITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 GRASMERE RD
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-2906
Mailing Address - Country:US
Mailing Address - Phone:610-213-7325
Mailing Address - Fax:
Practice Address - Street 1:123 GRASMERE RD
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-2906
Practice Address - Country:US
Practice Address - Phone:610-213-7325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-024685-E207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease