Healthcare Provider Details

I. General information

NPI: 1083933212
Provider Name (Legal Business Name): PAUL ABBOTT BRYANT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2010
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 PARK ST
NEW HAVEN CT
06519-1109
US

IV. Provider business mailing address

34 PARK ST
NEW HAVEN CT
06519-1109
US

V. Phone/Fax

Practice location:
  • Phone: 860-262-5432
  • Fax:
Mailing address:
  • Phone: 860-262-5432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number16627
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number55149
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number042.0012929
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: