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Individual
MR. BRYAN HOWARD QUACKENBUSH
Active
Individual
MR. BRYAN HOWARD QUACKENBUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
702414
NY
163W00000X
Registered Nurse
RN676013
PA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
404392
NY
Other
Enumeration date
01/11/2022
Last updated
08/21/2022
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