MEDICARE: DR. DAVID BYRON BROZYNA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	25MA05783200	NJ

General Provider Information

NPI Number	:	1114042462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID BYRON BROZYNA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1705
Second Line	:
City	:	RUTHERFORD
State	:	NJ
Zip	:	07070-0705
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	85 ORIENT WAY
Second Line	:	3RD FLOOR
City	:	RUTHERFORD
State	:	NJ
Zip	:	07070-2070
Country	:	US
Telephone Number	:	201-939-5500
Fax Number	:	201-939-1599

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	07/08/2007

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