Provider Demographics
NPI:1851743942
Name:BRYL, EMILY JEANNE (PA)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:JEANNE
Last Name:BRYL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:5120 MASTHEAD ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-4366
Mailing Address - Country:US
Mailing Address - Phone:505-243-7546
Mailing Address - Fax:505-243-7547
Practice Address - Street 1:5120 MASTHEAD ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4366
Practice Address - Country:US
Practice Address - Phone:505-243-7546
Practice Address - Fax:505-243-7547
Is Sole Proprietor?:No
Enumeration Date:2016-07-13
Last Update Date:2024-04-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NMPA20160066207N00000X
NM363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207N00000XAllopathic & Osteopathic PhysiciansDermatology