Provider Demographics
NPI:1356590004
Name:BRZEZNIAK, CHRISTINA ELLEN (DO)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:ELLEN
Last Name:BRZEZNIAK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1860 TOWN CENTER DR STE 460
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5901
Mailing Address - Country:US
Mailing Address - Phone:571-350-8400
Mailing Address - Fax:703-437-6549
Practice Address - Street 1:1860 TOWN CENTER DR STE 460
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5901
Practice Address - Country:US
Practice Address - Phone:703-437-6535
Practice Address - Fax:703-437-6549
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102205136207RH0003X, 207RH0003X
NY251511-1207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1356590004Medicaid