Glenn Breda, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

001456 Issued in CT

Practice address

850 Atlantic St Unit 301
Bridgeport, CT 06604-5269

Phone

(203) 953-2722

NPI assigned

Aug 6, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1628208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1558035196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 ATLANTIC ST UNIT 301",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066045269",
            "telephone_number": "203-953-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 ATLANTIC ST UNIT 301",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066045269",
            "telephone_number": "203-953-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREDA",
        "first_name": "GLENN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-06",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CT",
            "license": "001456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bridgeportbreezes@outlook.com",
            "affiliation": "N",
            "address_1": "850 Atlantic St Unit 301",
            "city": "Bridgeport",
            "state": "CT",
            "country_code": "US",
            "postal_code": "066045269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Portia Brantley, LMT
• Meryl Simcha Braun, MD
• Elizabeth Braungart, ND
• Giancarlo Bravo-Laguna
• Dawanda Brayboy, RN
• Stephen Dean Breda, M.D.
• Cara Ruth Brennan
• Rachel Brennan, LCSW
• Marlene Katherine Bresky, PA-C
• An Bressner

• Massage Therapist in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Massage Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.