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Individual

DR. STEWART A BRAZIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
949 CENTRAL AVE, STE 102, WOODMERE, NY 11598-1204
(516) 825-8910
(516) 825-8911
Mailing address
949 CENTRAL AVE, STE 102, WOODMERE, NY 11598-1204
(516) 825-8910
(516) 825-8911

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
120299
NY
207N00000X
Dermatology Physician
31181
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0045165
GHI
NY
05
00668355
NY
01
070002629
RAILROAD MEDICARE
NY
Enumeration date
03/01/2006
Last updated
10/06/2011
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