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General NPI Number Information
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NPI Number | 1265296016
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Entity Type | Organization
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Legal Business Name | LISA BRYHN MD LLC
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Dates
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Enumeration Date | 02/12/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 1056 STELTON RD
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City | PISCATAWAY
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State | NJ
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Zip | 08854-4326
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Country | US
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Telephone | 732-463-0303
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Fax | 732-463-2289
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Provider Business Mailing Address
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Address Line | 28 CHERRYVILLE HOLLOW RD
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City | FLEMINGTON
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State | NJ
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Zip | 08822-5526
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Country | US
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Telephone | 908-625-8867
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LISA BRYHN
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Credential |
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Telephone | 908-625-8867
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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