Individual
BRIAN CRUICKSHANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14 TECHNOLOGY DR, SUITES 11 & 12, EAST SETAUKET, NY 11733-3472
(631) 444-4233
Mailing address
14 TECHNOLOGY DR, SUITES 11 & 12, EAST SETAUKET, NY 11733-3472
(631) 444-4233
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
60 271708
NY
225100000X
Physical Therapist
023719-1
NY
Other
Enumeration date
10/06/2008
Last updated
08/14/2013
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