Provider Demographics
NPI:1972957769
Name:DWORSKY, BRYAN WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:WILLIAM
Last Name:DWORSKY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:711 TROY SCHENECTADY RD STE 201
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2482
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:2524 ROUTE 9W
Practice Address - Street 2:
Practice Address - City:RAVENA
Practice Address - State:NY
Practice Address - Zip Code:12143-2804
Practice Address - Country:US
Practice Address - Phone:518-756-7390
Practice Address - Fax:518-756-8030
Is Sole Proprietor?:No
Enumeration Date:2016-04-18
Last Update Date:2019-06-25
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Provider Licenses
StateLicense IDTaxonomies
NY297621207Q00000X
NY63707207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine