Provider Demographics
NPI:1619163938
Name:BRYNIEN, ROBERT K (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:K
Last Name:BRYNIEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HARLEYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19438-2416
Mailing Address - Country:US
Mailing Address - Phone:215-256-9909
Mailing Address - Fax:
Practice Address - Street 1:272 MAIN ST
Practice Address - Street 2:
Practice Address - City:HARLEYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19438-2416
Practice Address - Country:US
Practice Address - Phone:215-256-9909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-20
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6707P152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0909870001Medicare NSC
PA0908970001Medicare NSC
PAU10696Medicare PIN