Individual
DR. BRUCE RANDOLPH TIZES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2112 BROADWAY, SUITE 6F, NEW YORK, NY 10023-2105
(312) 513-6930
Mailing address
2112 BROADWAY, SUITE 6F, NEW YORK, NY 10023-2105
(312) 513-6930
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
160717
NY
Other
Enumeration date
07/27/2011
Last updated
07/27/2011
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