Individual
DR. LANCE RICHARD BRUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1601 TENBROECK AVE, BRONX, NY 10461-2007
(718) 430-8701
Mailing address
42 ROCK SHELTER RD, WACCABUC, NY 10597-1034
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
200006
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01833898
—
NY
Enumeration date
01/24/2007
Last updated
10/09/2024
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