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General NPI Number Information
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NPI Number | 1477909778
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Entity Type | Organization
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Legal Business Name | ISLAND CARDIOLOGY, PLLC
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Dates
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Enumeration Date | 05/05/2016
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Last Update Date | 05/05/2016
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Provider Practice Location Address
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Address Line | 1328 LAKE PARK BLVD N SUITE 103
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City | CAROLINA BEACH
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State | NC
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Zip | 28428-3935
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Country | US
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Telephone | 910-262-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 1328 LAKE PARK BLVD N SUITE 103
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City | CAROLINA BEACH
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State | NC
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Zip | 28428-3935
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Country | US
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Telephone | 910-262-6300
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAMIAN A BREZINSKI
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Credential | MD
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Telephone | 910-262-6300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 218894
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License Number State | NC
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