Individual
MR. BRUCE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR LICENSE
Contact information
Practice address
4319 CHURCH AVE, BROOKLYN, NY 11203-3101
(718) 978-3186
(718) 221-5530
Mailing address
609 MIDWOOD ST, BROOKLYN, NY 11203-1103
(718) 978-3188
(718) 221-5530
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
005500
NY
Other
Enumeration date
04/17/2007
Last updated
08/01/2013
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