Provider Demographics
NPI:1295772408
Name:REMO, BRYON
Entity type:Individual
Prefix:
First Name:BRYON
Middle Name:
Last Name:REMO
Suffix:
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 1:519 HERITAGE ROAD
Mailing Address - Street 2:SUITE 2K
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488
Mailing Address - Country:US
Mailing Address - Phone:203-577-9194
Mailing Address - Fax:203-272-9094
Practice Address - Street 1:519 HERITAGE ROAD
Practice Address - Street 2:SUITE 2K
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488
Practice Address - Country:US
Practice Address - Phone:203-577-9194
Practice Address - Fax:203-272-9094
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist