Individual
BRYAN BURROUGHS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTIONER
Contact information
Practice address
1200A SCOTTSVILLE RD STE 39, ROCHESTER, NY 14624-5703
(585) 319-0785
Mailing address
28 HARVEST RIDGE TRL, WEST HENRIETTA, NY 14586-8920
(585) 319-0785
(585) 287-6288
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F4022251
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1161
—
NY
Enumeration date
08/12/2013
Last updated
04/08/2025
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