Healthcare Provider Details
I. General information
NPI: 1124184429
Provider Name (Legal Business Name): EDNA ANNE PYTLAK, MD & BRIANNE O'CONNOR, MD, LLP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
35 MONROE PL
BROOKLYN NY
11201-2602
US
IV. Provider business mailing address
35 MONROE PL
BROOKLYN NY
11201-2602
US
V. Phone/Fax
- Phone: 718-834-1007
- Fax:
- Phone: 718-834-1007
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
BRIANNE
O'CONNOR
Title or Position: PARTNER
Credential: M.D.
Phone: 718-834-1007