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Organization

OLD COUNTRY PEDIATRICS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLES L BRUZZONE MD (PRESIDENT)
(516) 938-3232
Entity
Organization

Contact information

Practice address
556 OLD COUNTRY RD, PLAINVIEW, NY 11803
(516) 938-3232
Mailing address
556 OLD COUNTRY RD, PLAINVIEW, NY 11803
(516) 938-3232
(516) 938-8443

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
181879
NY

Other

Enumeration date
09/02/2006
Last updated
08/22/2020
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