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General NPI Number Information
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NPI Number | 1104994540
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Entity Type | Organization
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Legal Business Name | BRYAN G. FORLEY, M.D., P.C.
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Dates
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Enumeration Date | 12/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5 E 82ND ST
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City | NEW YORK
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State | NY
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Zip | 10028-0342
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Country | US
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Telephone | 212-861-3757
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Fax | 212-861-5033
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Provider Business Mailing Address
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Address Line | 5 EAST 82ND STREET
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City | NEW YORK
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State | NY
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Zip | 10028
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Country | US
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Telephone | 212-861-3757
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Fax | 212-861-5033
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRYAN G. FORLEY
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Credential | M.D.
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Telephone | 212-861-3757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 168207
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License Number State | NY
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