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Individual

DR. BRUCE WILLIAM SURACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
59 MIDDLE COUNTRY RD, MIDDLE ISLAND, NY 11953-2502
(631) 732-1615
(631) 732-1612
Mailing address
59 MIDDLE COUNTRY RD, MIDDLE ISLAND, NY 11953-2502
(631) 732-1615
(631) 732-1612

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X005240
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C052409
W COMP
NY
Enumeration date
10/04/2005
Last updated
12/06/2011
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