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NPI Code Detail

MEDICARE: DR. TAMAR BRYK D.D.S.

MEDICARE: DR. TAMAR BRYK D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry041816NY

General Provider Information

NPI Number : 1225124282
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TAMAR BRYK D.D.S.
Provider Business Mailing Address
First Line : 19215 RADNOR RD
Second Line :
City : HOLLIS
State : NY
Zip : 11423-1026
Country : US
Telephone Number : 718-217-4649
Fax Number :
Provider Business Practice Location Address
First Line : 3122 STEINWAY ST
Second Line :
City : ASTORIA
State : NY
Zip : 11103-3909
Country : US
Telephone Number : 718-278-2441
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2006
Last Update Date : 07/08/2007

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