Healthcare Provider Details

I. General information

NPI: 1528400249
Provider Name (Legal Business Name): BRYLIN HOSPITALS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2013
Last Update Date: 07/07/2023
Certification Date: 07/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

531 FARBER LAKES DR
WILLIAMSVILLE NY
14221-5773
US

IV. Provider business mailing address

1263 DELAWARE AVE
BUFFALO NY
14209-2402
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

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