Provider Demographics
NPI:1285723874
Name:BRAZIUNIENE, IEVA (MD)
Entity type:Individual
Prefix:
First Name:IEVA
Middle Name:
Last Name:BRAZIUNIENE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 COOPER PLZ
Mailing Address - Street 2:SUITE 502
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1438
Mailing Address - Country:US
Mailing Address - Phone:856-968-7433
Mailing Address - Fax:
Practice Address - Street 1:3 COOPER PLZ
Practice Address - Street 2:SUITE 200
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1438
Practice Address - Country:US
Practice Address - Phone:856-968-8898
Practice Address - Fax:856-968-8897
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA079106208000000X, 2080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ60019731OtherHORIZON NJ HEALTH
NJ9433703OtherCIGNA
NJ0081124Medicaid
NJ010007638OtherAMERICHOICE
NJ3970985OtherAETNA
NJUNIVERSITY HEALTH PLOther42283
NJP2753910OtherOXFORD
NJ2566050OtherUNITED HEALTHCARE
NJ1786414OtherAMERIHEALTH PPO/IBC
NJ2623623000OtherAMERIHEALTH/KEYSTONE/IBC
NJ3K5983OtherHEALTHNET
NJ3K5983OtherHEALTHNET
NJ2566050OtherUNITED HEALTHCARE