Healthcare Provider Details

I. General information

NPI: 1164534202
Provider Name (Legal Business Name): PAUL-MARIE JEROME BRISSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 11/15/2022
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 - E 25TH STREET 6TH FLOOR
NEW YORK CITY NY
10010
US

IV. Provider business mailing address

51 - E 25TH STREET 6TH FLOOR
NEW YORK CITY NY
10010
US

V. Phone/Fax

Practice location:
  • Phone: 212-813-3632
  • Fax: 212-696-0108
Mailing address:
  • Phone: 212-813-3632
  • Fax: 212-696-0108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number188579
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: