Individual
ALEX HARRY BRUCKSTEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2627 HYLAN BLVD, STATEN ISLAND, NY 10306-4339
(718) 667-3200
(718) 667-6615
Mailing address
2627 HYLAN BLVD, STATEN ISLAND, NY 10306-4339
(718) 667-3200
(718) 667-6615
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
NY129764
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
325101
MEDICARE PTAN
NY
Enumeration date
05/19/2006
Last updated
05/05/2010
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