Individual
LESLIE JEAN BRUSIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
942 ROUTE 376, SUITE 16, WAPPINGERS FALLS, NY 12590
(845) 223-8080
(845) 223-8081
Mailing address
942 ROUTE 376, SUITE 16, WAPPINGERS FALLS, NY 12590
(845) 223-8080
(845) 223-8081
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2028021
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00V731
BCBS
—
05
—
01775337
—
NY
01
—
10031841
CDPHP
—
01
—
141833509
TAX ID
—
01
—
1783916003
CIGNA
—
01
—
191724
WELLCARE
—
01
—
1976257
UNITED
—
01
—
2028021
LICENSE
—
01
—
2191726
AETNA
—
01
—
33D0991911
CLIA
—
01
—
4C1525
PHCS
—
01
—
53035
GHI HMO
—
01
—
5998555
GHI PPO
—
01
—
O87164
MVP
—
01
—
P2526879
OXFORD
—
Enumeration date
08/07/2006
Last updated
03/07/2023
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