Provider Demographics
NPI:1427206465
Name:LENCZEWSKI, BRIAN CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:CHRISTOPHER
Last Name:LENCZEWSKI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:856 J CLYDE MORRIS BLVD STE A
Mailing Address - Street 2:RIVERSIDE MEDICAL GROUP
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:757-594-4006
Mailing Address - Fax:
Practice Address - Street 1:109 PHILIP ROTH ST
Practice Address - Street 2:RIVERSIDE SURGICAL SPECIALISTS
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-1393
Practice Address - Country:US
Practice Address - Phone:757-873-6434
Practice Address - Fax:757-873-1882
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2016-12-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH57014130208600000X
PAMD437033208600000X
VA0101261568208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA159153JJMMedicare Oscar/Certification
PA1023324970001Medicaid