Provider Demographics
NPI:1720162126
Name:LA BRZOZOWSKI MD ER FLORES MD NEUROLOGICAL MEDICINE LTD
Entity Type:Organization
Organization Name:LA BRZOZOWSKI MD ER FLORES MD NEUROLOGICAL MEDICINE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRZOZOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-921-3890
Mailing Address - Street 1:1940 N 13TH ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19604
Mailing Address - Country:US
Mailing Address - Phone:610-921-3890
Mailing Address - Fax:610-921-3415
Practice Address - Street 1:1940 N 13TH ST
Practice Address - Street 2:SUITE 203
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19604
Practice Address - Country:US
Practice Address - Phone:610-921-3890
Practice Address - Fax:610-921-3415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-020772-E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty