Provider Demographics
NPI:1023542008
Name:MAYRSOHN, BRIAN (MD, MS)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:MAYRSOHN
Suffix:
Gender:M
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146A MANETTO HILL RD STE 100
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-1323
Mailing Address - Country:US
Mailing Address - Phone:516-200-4814
Mailing Address - Fax:
Practice Address - Street 1:146A MANETTO HILL RD STE 100
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1323
Practice Address - Country:US
Practice Address - Phone:516-523-1506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-17
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY317458208VP0000X, 207L00000X
NY317458-01208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine