Provider Demographics
NPI:1275610404
Name:BRYLA, ROBERT JAN (DC PT)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JAN
Last Name:BRYLA
Suffix:
Gender:M
Credentials:DC PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1912 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-5636
Mailing Address - Country:US
Mailing Address - Phone:315-733-1846
Mailing Address - Fax:315-733-7518
Practice Address - Street 1:1912 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-5636
Practice Address - Country:US
Practice Address - Phone:315-733-1846
Practice Address - Fax:315-733-7518
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX2043111N00000X
NY3556225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC020430OtherWORKERS COMP
30837CMedicare ID - Type UnspecifiedPT
30837BMedicare ID - Type UnspecifiedDC
NYC020430OtherWORKERS COMP