Individual
DR. BRIAN EDWARD SCULLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-8039
(212) 305-1754
Mailing address
630 W 168TH ST # 4, BOX 4, NEW YORK, NY 10032-3725
(212) 305-8039
(212) 305-1754
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
148465
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00708109
—
NY
Enumeration date
11/30/2006
Last updated
11/03/2016
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