Provider Demographics
NPI:1356526842
Name:BRYAN R. KOLBER
Entity type:Organization
Organization Name:BRYAN R. KOLBER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:KOLBER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:845-255-4414
Mailing Address - Street 1:66 N PUTT CORNERS RD
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-3405
Mailing Address - Country:US
Mailing Address - Phone:845-255-4414
Mailing Address - Fax:845-255-4415
Practice Address - Street 1:66 N PUTT CORNERS RD
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-3405
Practice Address - Country:US
Practice Address - Phone:845-255-4414
Practice Address - Fax:845-255-4415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies