Burroughs, Bryan Jay

Burroughs, Bryan Jay is an sole proprietor health care provider with primary practice located at 2 Coulter Rd , Clifton Springs NY 14432-1122. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as his primary health care specialty. Burroughs, Bryan Jay can be contacted via phone (315) 462-9561.

Contact Information

Primary practice address
2 Coulter Rd Clifton Springs NY 14432-1122
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X F4022251 New York

Profile Details

NPI number 1457784647
LBN Legal business name Burroughs, Bryan Jay
Credentials NURSE PRACTIONER
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 12th, 2013
Last updated Mar 17th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457784647 NPPES
New York MEDICAID 1161

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