Individual
BRYAN ALCIDES PABLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
718 TEANECK RD, TEANECK, NJ 07666-4245
(201) 968-1800
(201) 968-1814
Mailing address
PO BOX 22581, NEW YORK, NY 10087-2581
(856) 669-6050
(856) 528-3117
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
25MA09485200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0419443
—
NJ
Enumeration date
11/03/2011
Last updated
08/19/2021
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