Provider Demographics
NPI:1972265684
Name:DUDA, BRYANT MATTHEW (PHD)
Entity Type:Individual
Prefix:DR
First Name:BRYANT
Middle Name:MATTHEW
Last Name:DUDA
Suffix:
Gender:M
Credentials:PHD
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Other - Credentials:
Mailing Address - Street 1:2432 ALBANY AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-2535
Mailing Address - Country:US
Mailing Address - Phone:413-883-6413
Mailing Address - Fax:
Practice Address - Street 1:18 N MAIN ST STE 2E
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-9103
Practice Address - Country:US
Practice Address - Phone:203-272-6007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist