Provider Demographics
NPI:1952494783
Name:SAYLES, BRYAN JEFFREY (CPED)
Entity Type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:JEFFREY
Last Name:SAYLES
Suffix:
Gender:M
Credentials:CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 JOSEPH LN
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06415-2039
Mailing Address - Country:US
Mailing Address - Phone:860-537-0513
Mailing Address - Fax:
Practice Address - Street 1:159 BOSTON POST RD
Practice Address - Street 2:UNIT B
Practice Address - City:OLD LYME
Practice Address - State:CT
Practice Address - Zip Code:06371-1348
Practice Address - Country:US
Practice Address - Phone:860-434-6636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4887480001Medicare ID - Type Unspecified