Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 293079 | NY |
NPI | 1003229931 |
---|---|
Provider Name | Daniel Bryan |
First Address | East Syracuse, NY 13057-9581 |
Second Address | East Syracuse, NY 13057-9581 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2014 |
Last Update Date | 04/05/2021 |