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General NPI Number Information
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NPI Number | 1366696338
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Entity Type | Organization
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Legal Business Name | BRYAN O'YOUNG, M.D., P.C.
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Dates
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Enumeration Date | 11/04/2008
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Last Update Date | 11/04/2008
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Provider Practice Location Address
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Address Line | 265 CANAL ST SUITE 308
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City | NEW YORK
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State | NY
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Zip | 10013-6010
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Country | US
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Telephone | 212-219-8885
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Fax | 212-219-7527
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Provider Business Mailing Address
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Address Line | 265 CANAL ST SUITE 308
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City | NEW YORK
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State | NY
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Zip | 10013-6010
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Country | US
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Telephone | 212-219-8885
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Fax | 212-219-7527
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. BRYAN O'YOUNG
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Credential | MD
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Telephone | 212-219-8885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | A203035-1
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License Number State | NY
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