Individual
DR. ELIZABETH BRYNIARSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1100 CENTRAL AVE SE, 4TH FLOOR B, ALBUQUERQUE, NM 87106-4930
(505) 724-6124
(505) 724-6125
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
2002-0471
NM
2084N0400X
Neurology Physician
28251
OK
2084N0400X
Neurology Physician
28531
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200410970A
—
OK
01
—
28513
LICENSE
NE
Enumeration date
10/04/2006
Last updated
10/13/2016
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