Provider Demographics
NPI:1487035499
Name:MACKENZIE, BRIANNE (MD, MSC)
Entity Type:Individual
Prefix:
First Name:BRIANNE
Middle Name:
Last Name:MACKENZIE
Suffix:
Gender:F
Credentials:MD, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 FIRELANE 2A, R.R. #3
Mailing Address - Street 2:
Mailing Address - City:NIAGARA-ON-THE-LAKE
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:L051J0
Mailing Address - Country:CA
Mailing Address - Phone:347-275-0353
Mailing Address - Fax:
Practice Address - Street 1:100 HIGH STREET
Practice Address - Street 2:BUFFALO GENERAL HOSPITAL
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203
Practice Address - Country:US
Practice Address - Phone:716-859-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-16
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program