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General NPI Number Information
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NPI Number | 1417602681
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Entity Type | Individual
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Provider Name | MARIE BRYANT RN
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Gender | Female
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Dates
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Enumeration Date | 02/16/2022
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Last Update Date | 02/16/2022
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Provider Practice Location Address
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Address Line | 165-02 BAISLEY BLVD, QUEENS, NY 11434
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City | QUEENS
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State | NY
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Zip | 11434
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Country | US
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Telephone | 718-525-7642
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Fax |
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Provider Business Mailing Address
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Address Line | 18614 118TH RD
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City | SAINT ALBANS
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State | NY
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Zip | 11412-4002
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Country | US
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Telephone | 845-367-2986
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 527828
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License Number State | NY
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