Organization
ROBERT L BRUCKSTEIN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT L BRUCKSTEIN MD (PRESIDENT)
(516) 239-2332
Entity
Organization
Contact information
Practice address
290 CENTRAL AVE, SUITE 206, LAWRENCE, NY 11559-8507
(516) 239-2332
Mailing address
290 CENTRAL AVE, SUITE 206, LAWRENCE, NY 11559-8507
(516) 239-2332
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
117212-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00216904
—
NY
Enumeration date
11/10/2011
Last updated
11/10/2011
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