Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 25MA09577900 | NJ |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 276725 | NY |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 25MA09577900 | NJ |
NPI | 1447273487 |
---|---|
Provider Name | Agata K Brys |
First Address | Tarrytown, NY 10591-5139 |
Second Address | Parsippany, NJ 07054-2707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 23/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P01566443 | RAILROAD MEDICARE PIN (01) | NJ |