Individual
BRYAN CECIL PATRAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
133 PARK ST, MALONE, NY 12953-1244
(518) 481-6515
Mailing address
133 PARK ST, MALONE, NY 12953-1244
(518) 481-6515
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
280029
NC
363L00000X
Nurse Practitioner
Primary
432327
NY
Other
Enumeration date
12/13/2019
Last updated
09/07/2022
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