Individual
BRUCE L BRUSKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1304 RHAWN ST, PHILA, PA 19111-2870
(215) 742-1225
(215) 742-3902
Mailing address
1304 RHAWN ST, PHILADELPHIA, PA 19111-2870
(215) 514-8652
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
213E00000X
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000500788-0006
—
PA
05
—
000500788-0007
—
PA
Enumeration date
01/09/2006
Last updated
04/21/2020
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