Provider Demographics
NPI:1376749119
Name:DALBERTI-BRESCIA, PATRICIA (MD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:DALBERTI-BRESCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-5390
Mailing Address - Country:US
Mailing Address - Phone:201-659-7700
Mailing Address - Fax:201-659-7701
Practice Address - Street 1:1131 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-5390
Practice Address - Country:US
Practice Address - Phone:201-659-7700
Practice Address - Fax:201-659-7701
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA51790174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD04971300OtherCDS
NJMA51790OtherLICENSE
NJMA51790OtherLICENSE
NJ021064Medicare ID - Type Unspecified
NJE62573Medicare UPIN
NJMA51790OtherLICENSE
NJD04971300OtherCDS