Individual
DR. BRYAN ROSS TISCHENKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
622 W 168TH ST, PH5-133 STEM, NEW YORK, NY 10032-3720
(516) 993-6583
Mailing address
761 MIDDLE COUNTRY RD, SELDEN, NY 11784-3720
(631) 736-4064
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
283117
NY
Other
Enumeration date
03/28/2012
Last updated
09/11/2017
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