Organization
EMMA L BRYAN DPM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMMA BRYAN DPM (OWNER)
(609) 404-3200
Entity
Organization
Contact information
Practice address
29 S NEW YORK RD, STE 800, GALLOWAY, NJ 08205-9692
(609) 404-3200
(609) 404-4251
Mailing address
29 S NEW YORK RD, STE 800, GALLOWAY, NJ 08205-9692
(609) 404-3200
(609) 404-4251
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
MD0002522
NJ
332BC3200X
Customized Equipment (DME)
MD0002522
NJ
335E00000X
Prosthetic/Orthotic Supplier
MD250002522
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8133204
—
NJ
Enumeration date
01/16/2008
Last updated
09/05/2008
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