Individual
LISA BRUEFACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
100 PORT WASHINGTON BLVD, ROSLYN, NY 11576-1353
(516) 562-6602
(516) 562-6614
Mailing address
221 HARBOR HILL RD, ROSLYN, NY 11576-2209
(516) 484-1904
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
005205
NY
Other
Enumeration date
04/23/2007
Last updated
07/08/2007
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