Provider Demographics
NPI:1275895021
Name:PYSH, BRIAN DAVID (PSYD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:DAVID
Last Name:PYSH
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 CREAMERY RD
Mailing Address - Street 2:
Mailing Address - City:ELVERSON
Mailing Address - State:PA
Mailing Address - Zip Code:19520-9026
Mailing Address - Country:US
Mailing Address - Phone:610-836-1241
Mailing Address - Fax:
Practice Address - Street 1:640 WALNUT ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-3504
Practice Address - Country:US
Practice Address - Phone:610-208-8860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist