Healthcare Provider Details

I. General information

NPI: 1730269838
Provider Name (Legal Business Name): SANDRA ANN BRZEZINSKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 11/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

917 PHILADELPHIA AVE
NORTHERN CAMBRIA PA
15714
US

IV. Provider business mailing address

PO BOX 52 878 ECKENRODE MILLS ROAD
CHEST SPRINGS PA
16624-0052
US

V. Phone/Fax

Practice location:
  • Phone: 814-948-2945
  • Fax: 814-945-6500
Mailing address:
  • Phone: 814-674-5822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD034533E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: