Provider Demographics
NPI:1629740311
Name:BYRNE, JOHN J JR
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:BYRNE
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33130 N VILLAGE LOOP UNIT 3202
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-6273
Mailing Address - Country:US
Mailing Address - Phone:860-604-8469
Mailing Address - Fax:
Practice Address - Street 1:16287 WILLOW CREEK RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-3614
Practice Address - Country:US
Practice Address - Phone:302-703-6332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker