Provider Demographics
NPI:1235177890
Name:BRZOZOWSKI, ANETTE MARIA (DPM)
Entity Type:Individual
Prefix:DR
First Name:ANETTE
Middle Name:MARIA
Last Name:BRZOZOWSKI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 ROLLING GLN
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-9551
Mailing Address - Country:US
Mailing Address - Phone:856-787-0240
Mailing Address - Fax:
Practice Address - Street 1:163 HURFFVILLE CROSSKEYS ROAD
Practice Address - Street 2:
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012
Practice Address - Country:US
Practice Address - Phone:856-875-1000
Practice Address - Fax:856-875-9661
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00253900213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU74839Medicare UPIN
NJ0261815MU9Medicare ID - Type Unspecified