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General NPI Number Information
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NPI Number | 1750539789
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Entity Type | Individual
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Provider Name | JENNIFER K VAZQUEZ-BRYAN MD
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Gender | Female
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 08/24/2018
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Provider Practice Location Address
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Address Line | 6511 SPRING BROOK AVE
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City | RHINEBECK
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State | NY
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Zip | 12572
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Country | US
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Telephone | 845-876-3001
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Fax |
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Provider Business Mailing Address
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Address Line | 14 MCNALLY ST
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City | GOSHEN
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State | NY
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Zip | 10924-1104
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Country | US
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Telephone | 845-510-1870
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Fax | 845-510-1872
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 276666
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 276666
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License Number State | NY
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