Individual
CRYSTAL BRUCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3316 102ND ST, CORONA, NY 11368-1131
(347) 615-8701
Mailing address
3316 102ND ST, CORONA, NY 11368-1131
(347) 615-8701
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
01/28/2014
Last updated
01/28/2014
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