Provider Demographics
NPI:1386202307
Name:BRYTHONIC LLC
Entity Type:Organization
Organization Name:BRYTHONIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOTIST/ PROSTHETIST/ OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:BOCPO
Authorized Official - Phone:845-264-9569
Mailing Address - Street 1:90 BRYANT AVE, F6D
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-1916
Mailing Address - Country:US
Mailing Address - Phone:945-264-9569
Mailing Address - Fax:845-236-3704
Practice Address - Street 1:625 MCLEAN AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-4735
Practice Address - Country:US
Practice Address - Phone:845-264-9569
Practice Address - Fax:845-236-3704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-04
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Multi-Specialty
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment