Individual
MR. RAYMOND J BRUNJES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
269 ARCH ST, OCEANSIDE, NY 11572-4301
(516) 678-2182
(516) 608-0755
Mailing address
269 ARCH ST, OCEANSIDE, NY 11572-4301
(516) 678-2182
(516) 608-0755
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
5421
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5421
PHYSICAL THERAPIST
NY
Enumeration date
12/28/2008
Last updated
12/28/2008
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