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General NPI Number Information
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NPI Number | 1790969202
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Entity Type | Organization
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Legal Business Name | MARY ANNE BRAZINSKI DPM PA
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Dates
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Enumeration Date | 12/19/2007
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 3453 VALLEY RD
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City | BASKING RIDGE
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State | NJ
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Zip | 07920-2655
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Country | US
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Telephone | 908-604-2277
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Fax | 908-604-6219
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Provider Business Mailing Address
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Address Line | 3453 VALLEY RD
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City | BASKING RIDGE
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State | NJ
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Zip | 07920-2655
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Country | US
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Telephone | 908-604-2277
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Fax | 908-604-6219
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. MARY ANNE BRAZINSKI
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Credential | DPM
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Telephone | 908-604-2277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | MD0616
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | MD01616
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License Number State | NJ
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