Provider Demographics
NPI:1114465408
Name:DR BRYAN M WOLYNSKI OD PC
Entity Type:Organization
Organization Name:DR BRYAN M WOLYNSKI OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:WOLYNSKI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:212-375-1001
Mailing Address - Street 1:515 EAST 83RD STREET
Mailing Address - Street 2:#4A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-4148
Mailing Address - Country:US
Mailing Address - Phone:212-375-1001
Mailing Address - Fax:212-375-1105
Practice Address - Street 1:305 E 55TH ST
Practice Address - Street 2:SUITE 105
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-4148
Practice Address - Country:US
Practice Address - Phone:212-375-1001
Practice Address - Fax:212-375-1105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty