Dr. Edward George Bryant IV, OD
Optometrist in Ithaca, NY. Individual provider (NPI-1).
NPI number1790785384
StatusActive
Last updated in NPPESApr 17, 2019
Details
- NPI
- 1790785384
- Entity type
- Individual (NPI-1)
- Name
- Dr. Edward George Bryant IV
- Credential
- OD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 26, 2005
- Last updated
- Apr 17, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | TUV006637 | NY | Yes |
Practice location
1284 Dryden RoadIthaca, NY 14850-8795
Phone 607-257-1066 · Fax 607-257-1378
Mailing address
1284 Dryden RoadIthaca, NY 14850-8795
Phone 607-257-1066 · Fax 607-257-1378
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