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MR. BRUCE P. SEBASTIEN ELLISON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
1823 5TH AVE, BAY SHORE, NY 11706-1721
(631) 291-9975
Mailing address
136 GRAND ST, BROOKLYN, NY 11249-4208
(917) 861-3758

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
010457-01
NY

Other

Enumeration date
03/28/2023
Last updated
03/28/2023
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