Individual
DR. BRUCE ALAN DORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
6134 188TH ST, SUITE 203, FRESH MEADOWS, NY 11365-2726
(718) 454-4333
(718) 454-4823
Mailing address
30 HIGHTOP LN, JERICHO, NY 11753-1719
(516) 938-2055
(718) 454-4823
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
1495
FL
213E00000X
Podiatrist
Primary
NY003551
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0025415
GHI
NY
05
—
00818933
—
NY
01
—
P38382
BLUE CROSS
NY
01
—
P559929
OXFORD INSURANCE
NY
Enumeration date
08/15/2005
Last updated
09/30/2012
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