Individual
DR. JEAN M. BRUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., D.M.D.
Contact information
Practice address
243 CHARLES ST, BOSTON, MA 02114-3002
(617) 573-3793
Mailing address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1047
(617) 573-3793
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
158669
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3185443
—
MA
Enumeration date
10/31/2005
Last updated
03/03/2020
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