Individual
BRYAN THOMAS NEWCOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
301 PROSPECT AVE, SYRACUSE, NY 13203-1807
(315) 730-8509
Mailing address
305 ELLINGTON CT, CAMILLUS, NY 13031-2051
(315) 730-8509
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
648254-01
NY
163W00000X
Registered Nurse
RN713702
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
648254-01
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/20/2020
Last updated
06/22/2021
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