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Individual

JUSTIN BRUITCHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
225 BROADHOLLOW RD STE 402, MELVILLE, NY 11747-4899
(631) 385-7780
Mailing address
629 ROSE BLVD, NORTH BALDWIN, NY 11510-1025

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
05/25/2023
Last updated
05/25/2023
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