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Individual

DEWITT PYBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10 UNION SQ E, NEW YORK, NY 10003-3314
(212) 844-8888
Mailing address
PO BOX 5806, NEW YORK, NY 10087-5806
(212) 256-3539

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
197403
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01783619
NY
Enumeration date
11/03/2005
Last updated
06/04/2014
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