Provider Demographics
NPI:1801256359
Name:BREZA, ANDREW STEVEN (EMT)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:STEVEN
Last Name:BREZA
Suffix:
Gender:M
Credentials:EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4122 EDMUNDS ST NW
Mailing Address - Street 2:#202
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-3916
Mailing Address - Country:US
Mailing Address - Phone:202-683-9021
Mailing Address - Fax:
Practice Address - Street 1:5 JAPONICA DR
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-9519
Practice Address - Country:US
Practice Address - Phone:202-683-9021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-26
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA100572146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic