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General NPI Number Information
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NPI Number | 1538080544
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Entity Type | Individual
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Provider Name | BRYANT IZURIETA PA-C, R.T.
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Gender | Male
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Dates
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Enumeration Date | 07/24/2026
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Last Update Date | 07/24/2026
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Provider Practice Location Address
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Address Line | 1 BROOKDALE PLZ
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City | BROOKLYN
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State | NY
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Zip | 11212-3198
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Country | US
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Telephone | 718-240-5250
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Fax |
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Provider Business Mailing Address
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Address Line | 66 TULIP AVE APT 7B
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City | FLORAL PARK
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State | NY
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Zip | 11001-1812
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Country | US
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Telephone | 917-703-3457
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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 | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 036114
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License Number State | NY
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