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Individual

DR. BRUCE EDWARD WAXMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
19 BAKER AVE, STE. 203, POUGHKEEPSIE, NY 12601-1370
(845) 471-2243
(845) 298-7750
Mailing address
19 BAKER AVE, STE. 203, POUGHKEEPSIE, NY 12601-1359
(845) 471-2243
(845) 298-7750

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N03143
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00671265
NY
Enumeration date
11/13/2006
Last updated
05/20/2016
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