Basic Information
| Provider Information | |||||||||
| NPI: | 1922292085 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROY | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | RENE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 803 OSTRUM ST. | ||||||||
| Address2: | EMERGENCY MEDICINE DEPARTMENT | ||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 18015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6109544903 | ||||||||
| FaxNumber: | 6109542153 | ||||||||
| Practice Location | |||||||||
| Address1: | 803 OSTRUM ST. | ||||||||
| Address2: | EMERGENCY MEDICINE DEPARTMENT | ||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 18015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6109544903 | ||||||||
| FaxNumber: | 6109542153 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2007 | ||||||||
| LastUpdateDate: | 08/31/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | OS013847 | PA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.