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NPI Code Detail

MEDICARE: DR. DUANE B. BRYAN M.D.

MEDICARE: DR. DUANE B. BRYAN 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
1207RC0000XCardiovascular Disease Physician208648-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457370728
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DUANE B. BRYAN M.D.
Provider Business Mailing Address
First Line : 206 ROUTE 303
Second Line :
City : VALLEY COTTAGE
State : NY
Zip : 10989-2019
Country : US
Telephone Number : 845-767-5259
Fax Number :
Provider Business Practice Location Address
First Line : 206 ROUTE 303
Second Line :
City : VALLEY COTTAGE
State : NY
Zip : 10989-2019
Country : US
Telephone Number : 845-268-0880
Fax Number : 845-268-0882
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 01/18/2017

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