Individual
DR. JOHN JOSEPH O'BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 NORTHERN DR, TROY, NY 12182-1821
(518) 237-7363
(518) 237-8995
Mailing address
200 NORTHERN DR, TROY, NY 12182-1821
(518) 237-7363
(518) 237-8995
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
169022-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000401303001
BLUE SHIELD NENY
NY
05
—
01074120
—
NY
01
—
080014389
RAILROAD MEDICARE
NY
01
—
08019
MVP
NY
01
—
10002770
CAPITAL DISTRICT PHYSICIA
NY
01
—
29F291
EMPIRE BC-BS
NY
Enumeration date
06/08/2006
Last updated
10/04/2011
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