Healthcare Provider Details

I. General information

NPI: 1982833588
Provider Name (Legal Business Name): MARCIA ELAINE BRZEZINSKI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2009
Last Update Date: 07/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 FRANKLIN 400
BUFFALO NY
14202-2414
US

IV. Provider business mailing address

1353 WESTWOOD AVE
NORTH TONAWANDA NY
14120-2318
US

V. Phone/Fax

Practice location:
  • Phone: 716-856-2702
  • Fax: 716-856-8034
Mailing address:
  • Phone: 716-693-7599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number226784-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: