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General NPI Number Information
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NPI Number | 1558415752
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Entity Type | Individual
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Provider Name | BRUCE A KAHN J.D., M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 10/22/2009
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Provider Practice Location Address
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Address Line | 201 PROSPECT AVE
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City | SYRACUSE
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State | NY
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Zip | 13203-1805
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Country | US
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Telephone | 315-448-6463
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Fax | 315-448-6510
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Provider Business Mailing Address
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Address Line | 9 ENRIGHT STREET
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City | MYSTERTON
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State | QUEENSLAND
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Zip | 4812
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Country | AU
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Telephone | 61747753088
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Fax | 435-604-6725
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 178464
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License Number State | NY
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