Individual
MS. GWEN M BRUSZEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
200 BELLE TERRE RD, PORT JEFFERSON, NY 11777-1928
(631) 474-6492
(631) 474-6193
Mailing address
11 FAIRWAY DR, MANORVILLE, NY 11949-2909
(631) 874-0638
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
03/01/2007
Last updated
07/08/2007
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