Provider Demographics
NPI:1588628622
Name:BREZINSKY, DARLENE D (NP)
Entity Type:Individual
Prefix:MS
First Name:DARLENE
Middle Name:D
Last Name:BREZINSKY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 423
Mailing Address - Street 2:
Mailing Address - City:PENN YAN
Mailing Address - State:NY
Mailing Address - Zip Code:14527-0423
Mailing Address - Country:US
Mailing Address - Phone:315-531-9102
Mailing Address - Fax:315-531-9103
Practice Address - Street 1:160 MAIN ST
Practice Address - Street 2:
Practice Address - City:PENN YAN
Practice Address - State:NY
Practice Address - Zip Code:14527-1204
Practice Address - Country:US
Practice Address - Phone:315-536-2752
Practice Address - Fax:315-536-4005
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF300695-1363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02565713Medicaid
NYP019300695OtherBLUE CHOICE
NYNP0193OtherPREFERRED CARE
NYS85394Medicare UPIN
NY02565713Medicaid
NYP019300695OtherBLUE CHOICE