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NPI Code Detail

MEDICARE: PATRICIA BRYANT

MEDICARE: PATRICIA BRYANT
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
11041C0700XClinical Social Worker024836NY

General Provider Information

NPI Number : 1134294861
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA BRYANT
Provider Business Mailing Address
First Line : 189 MONTAGUE ST
Second Line : SUITE 418
City : BROOKLYN
State : NY
Zip : 11201-3610
Country : US
Telephone Number : 718-875-7510
Fax Number : 718-643-3455
Provider Business Practice Location Address
First Line : 189 MONTAGUE ST
Second Line : SUITE 436
City : BROOKLYN
State : NY
Zip : 11201-3610
Country : US
Telephone Number : 718-875-5625
Fax Number : 718-875-6876
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2006
Last Update Date : 01/11/2008

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Directions to “ PATRICIA BRYANT ” Practice Location

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