Provider Demographics
NPI:1508904269
Name:BREZNAK, CINDY MARIE (MD)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:MARIE
Last Name:BREZNAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 JAMES STREET
Mailing Address - Street 2:SUITE 210
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-3902
Mailing Address - Country:US
Mailing Address - Phone:732-744-1800
Mailing Address - Fax:732-744-1837
Practice Address - Street 1:98 JAMES STREET
Practice Address - Street 2:SUITE 210
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3902
Practice Address - Country:US
Practice Address - Phone:732-744-1800
Practice Address - Fax:732-744-1837
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05169500207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5084000Medicaid
F00169Medicare UPIN
004231Medicare ID - Type Unspecified