Provider Demographics
NPI:1003467895
Name:BYRNE, MICHAEL JAMES (NYCPS)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JAMES
Last Name:BYRNE
Suffix:
Gender:M
Credentials:NYCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 WEST 232ND STREET
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3207
Mailing Address - Country:US
Mailing Address - Phone:718-884-2992
Mailing Address - Fax:718-884-2901
Practice Address - Street 1:640 WEST 232ND STREET
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3207
Practice Address - Country:US
Practice Address - Phone:718-884-2992
Practice Address - Fax:718-884-2901
Is Sole Proprietor?:No
Enumeration Date:2019-09-24
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175T00000X
NYNYCPS-2555175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist