Basic Information
| Provider Information | |||||||||
| NPI: | 1578661377 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HANYPSIAK | ||||||||
| FirstName: | BRYAN | ||||||||
| MiddleName: | T. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 11392 | ||||||||
| Address2: | |||||||||
| City: | BELFAST | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049154004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8669491433 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6101 PINE RIDGE RD | ||||||||
| Address2: | |||||||||
| City: | NAPLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 34119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2393484221 | ||||||||
| FaxNumber: | 2393484148 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2006 | ||||||||
| LastUpdateDate: | 09/16/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 232368 | NY | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | ME123624 | FL | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 002639816 | 05 | NY | MEDICAID |