Individual
MR. BRUCE PAUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
25 LAKE ST, APT. 2F, WHITE PLAINS, NY 10603-4032
(914) 948-3158
Mailing address
25 LAKE STREET, APT. 2F, WHITE PLAINS, NY 10603-4013
(914) 948-3158
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
331977
NY
Other
Enumeration date
05/30/2012
Last updated
05/30/2012
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