Provider Demographics
NPI:1225335151
Name:BREZINSKI, SHARON J (PA-C)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:J
Last Name:BREZINSKI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:J
Other - Last Name:PILLSBURY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:287 MAIN ST
Mailing Address - Street 2:STE.302
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7054
Mailing Address - Country:US
Mailing Address - Phone:207-795-6543
Mailing Address - Fax:207-795-0488
Practice Address - Street 1:287 MAIN ST
Practice Address - Street 2:STE.302
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7054
Practice Address - Country:US
Practice Address - Phone:207-795-6543
Practice Address - Fax:207-795-0488
Is Sole Proprietor?:No
Enumeration Date:2011-02-11
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA1258363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME0025193Medicare PIN
ME002519301Medicare PIN
MEP01049658Medicare PIN