MEDICARE: BRYN JAMES DUFFY MD

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
1	207R00000X	Internal Medicine Physician	A110571	CA

General Provider Information

NPI Number	:	1235243775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRYN JAMES DUFFY MD

Provider Business Mailing Address
First Line	:	80 RAMBLEWOOD DR
Second Line	:
City	:	NORTH CHILI
State	:	NY
Zip	:	14514-1033
Country	:	US
Telephone Number	:	585-349-9958
Fax Number	:

Provider Business Practice Location Address
First Line	:	16 BOLANOS DR
Second Line	:
City	:	SAN RAFAEL
State	:	CA
Zip	:	94903-3103
Country	:	US
Telephone Number	:	415-306-1560
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	02/01/2010

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