Individual
MR. BRIAN M. JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-2000
Mailing address
1275 YORK AVE, NEW YORK, NY 10065-6007
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
010058
NY
363AS0400X
Surgical Physician Assistant
25MP00197700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03971088
—
NY
Enumeration date
02/13/2007
Last updated
12/09/2019
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