Judith Brysk MD PLLC

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

4301049453 Issued in MI

Legal business name

JUDITH BRYSK MD PLLC

Practice address

25865 W. 12 Mile Rd.
Suite A101
Southfield, MI 48034

Phone

(248) 948-1990

Fax

(248) 948-9158

NPI assigned

May 15, 2008

Last updated

Apr 15, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Judith Gail Brysk, MD

Title

MD

Phone

(248) 948-1990

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397520000000",
    "number": "1093982241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6632 TELEGRAPH RD.",
            "address_2": "# 168",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "48301",
            "telephone_number": "248-948-1990",
            "fax_number": "248-948-9158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25865 W. 12 MILE RD.",
            "address_2": "SUITE A101",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48034",
            "telephone_number": "248-948-1990",
            "fax_number": "248-948-9158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUDITH BRYSK MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2014-04-15",
        "status": "A",
        "authorized_official_last_name": "BRYSK",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "GAIL",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "248-948-1990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MI",
            "license": "4301049453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.