Individual
MR. BRYAN D HATHAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
115 HICKORIES PARK RD, OWEGO, NY 13827-4845
(607) 687-7645
(607) 687-7646
Mailing address
115 HICKORIES PARK ROAD, OWEGO, NY 13827
(607) 687-7645
(607) 687-7646
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0116511
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10054748
CDPHP
NY
01
—
7357124
AETNA
NY
Enumeration date
12/19/2006
Last updated
01/27/2025
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