Individual
BRYAN MATTHEW FEDONICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1 CHIMNEY POINT DR, OGDENSBURG, NY 13669-2212
(315) 541-2500
Mailing address
935 W MAHONEY RD, BRASHER FALLS, NY 13613-4213
(315) 250-2700
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
772611
NY
Other
Enumeration date
05/02/2024
Last updated
01/17/2025
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