Healthcare Provider Details

I. General information

NPI: 1609849819
Provider Name (Legal Business Name): PAUL NEIL BRYMAN DO, FACOI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 E LAUREL RD STE 1800
STRATFORD NJ
08084-1338
US

IV. Provider business mailing address

42 E LAUREL RD STE 1800
STRATFORD NJ
08084-1338
US

V. Phone/Fax

Practice location:
  • Phone: 856-566-6843
  • Fax: 856-566-6419
Mailing address:
  • Phone: 856-566-6843
  • Fax: 856-566-6419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MB04459300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number25MB04459300
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number25MB04459300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: