Provider Demographics
NPI:1982833588
Name:BRZEZINSKI, MARCIA ELAINE (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:ELAINE
Last Name:BRZEZINSKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1353 WESTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-2318
Mailing Address - Country:US
Mailing Address - Phone:716-693-7599
Mailing Address - Fax:
Practice Address - Street 1:170 FRANKLIN
Practice Address - Street 2:400
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202-2414
Practice Address - Country:US
Practice Address - Phone:716-856-2702
Practice Address - Fax:716-856-8034
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226784-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00846960Medicaid