Healthcare Provider Details

I. General information

NPI: 1194728691
Provider Name (Legal Business Name): BRYLIN HOSPITALS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 07/07/2023
Certification Date: 07/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1263 DELAWARE AVE
BUFFALO NY
14209
US

IV. Provider business mailing address

1263 DELAWARE AVE
BUFFALO NY
14209-2402
US

V. Phone/Fax

Practice location:
  • Phone: 716-886-8200
  • Fax: 716-886-2456
Mailing address:
  • Phone: 716-886-8200
  • Fax: 716-886-2456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number7340022
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number070410683
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number050410687
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number7340020
License Number StateNY

VIII. Authorized Official

Name: MR. MARK CYE
Title or Position: PRESIDENT
Credential:
Phone: 716-886-8200