Provider Demographics
NPI:1386629764
Name:BRYSON, JOSEPH ANTHONY (DC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ANTHONY
Last Name:BRYSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 BURNSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-2685
Mailing Address - Country:US
Mailing Address - Phone:908-531-0073
Mailing Address - Fax:732-596-0335
Practice Address - Street 1:446 RAHWAY AVE
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095-3305
Practice Address - Country:US
Practice Address - Phone:732-596-0333
Practice Address - Fax:732-596-0335
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00510200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0027448Medicaid
NJU68924Medicare UPIN
NJ005543Medicare ID - Type Unspecified