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General NPI Number Information
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NPI Number | 1942992235
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Entity Type | Organization
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Legal Business Name | BRIAN MAYRSOHN MD PLLC
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Dates
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Enumeration Date | 05/24/2023
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 200 BELLE TERRE RD STE 300
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City | PORT JEFFERSON
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State | NY
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Zip | 11777-1928
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Country | US
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Telephone | 631-780-4470
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Fax | 914-366-6101
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Provider Business Mailing Address
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Address Line | PO BOX 2067
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City | OLDSMAR
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State | FL
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Zip | 34677-7067
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Country | US
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Telephone | 914-366-6161
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Fax | 914-366-6101
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DEBORAH STANCO
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Credential |
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Telephone | 516-458-0831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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