MEDICARE: ROBERT LESLIE BRYANT 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	308582	NY

General Provider Information

NPI Number	:	1366897829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT LESLIE BRYANT M.D.

Provider Business Mailing Address
First Line	:	56 MORTON ST APT 5W
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10014-4036
Country	:	US
Telephone Number	:	917-972-3061
Fax Number	:

Provider Business Practice Location Address
First Line	:	56 MORTON ST APT 5W
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10014-4036
Country	:	US
Telephone Number	:	917-972-3061
Fax Number	:

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

Provider Enumeration Date	:	05/03/2016
Last Update Date	:	09/21/2023

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