Individual
KENNETH I. BRYDGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
100 HORWOOD PLACE, OGDENSBURG, NY 13669
(315) 394-0426
Mailing address
100 HORWOOD PLACE, OGDENSBURG, NY 13669
(315) 394-0426
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
239404
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02824862
—
NY
Enumeration date
11/09/2006
Last updated
09/09/2022
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