Individual
CONSTANCE MARIE BRUST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16 ROCK RD, ISLIP TERRACE, NY 11752-1910
(631) 748-4915
Mailing address
16 ROCK RD, ISLIP TERRACE, NY 11752-1910
(631) 748-4915
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
536467
NY
Other
Enumeration date
07/13/2013
Last updated
11/16/2014
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