Provider Demographics
NPI:1063683548
Name:BRYANT, HUGH (DPM)
Entity Type:Individual
Prefix:DR
First Name:HUGH
Middle Name:
Last Name:BRYANT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 UTICA AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-4942
Mailing Address - Country:US
Mailing Address - Phone:718-604-8370
Mailing Address - Fax:718-221-8944
Practice Address - Street 1:319 UTICA AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-4942
Practice Address - Country:US
Practice Address - Phone:718-604-8370
Practice Address - Fax:718-221-8944
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN002597213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP2949100Medicare PIN