MEDICARE: DR. MARIANO EZEQUIEL BRIZZIO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	268336	NY
2	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	0101286989	VA
3	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	MD491952	PA
4	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	ME145083	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	25MA08127100	OTHER	NJ	LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851468508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIANO EZEQUIEL BRIZZIO M.D.

Provider Business Mailing Address
First Line	:	3803 W CHESTER PIKE STE 160
Second Line	:
City	:	NEWTOWN SQUARE
State	:	PA
Zip	:	19073-2336
Country	:	US
Telephone Number	:	484-476-1000
Fax Number	:	484-476-9000

Provider Business Practice Location Address
First Line	:	100 E LANCASTER AVE
Second Line	:	THE HEART PAVILION, MEZZANINE LEVEL
City	:	WYNNEWOOD
State	:	PA
Zip	:	19096-3450
Country	:	US
Telephone Number	:	484-476-1000
Fax Number	:	484-476-9000

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	01/09/2026

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Directions to “ DR. MARIANO EZEQUIEL BRIZZIO M.D.” Practice Location

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