Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 168207-1 | NY |
NPI | 1295902963 |
---|---|
Provider Name | Dr. Bryan G. Forley |
First Address | New York, NY 10028-0342 |
Second Address | New York, NY 10028-0342 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2008 |
Last Update Date | 13/05/2008 |