Individual
BRUCE LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
170 WILLIAM ST, FL 7, NEW YORK, NY 10038-2612
(212) 312-5000
Mailing address
170 WILLIAM ST, FL 7, NEW YORK, NY 10038-2612
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
123160
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123160
LICENSE
NY
Enumeration date
01/10/2007
Last updated
10/15/2013
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