Provider Demographics
NPI:1033221544
Name:JULIEN-BRIZAN, VERN M (NP)
Entity Type:Individual
Prefix:MS
First Name:VERN
Middle Name:M
Last Name:JULIEN-BRIZAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 MIDWOOD ST
Mailing Address - Street 2:APT 2G
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-1457
Mailing Address - Country:US
Mailing Address - Phone:718-604-3531
Mailing Address - Fax:
Practice Address - Street 1:3414 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2714
Practice Address - Country:US
Practice Address - Phone:718-940-9425
Practice Address - Fax:718-940-2914
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF332349363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYS85304Medicare UPIN