Individual
FREDRIC M BRUSTEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3 PILGRIM HOLLOW RD., WAYSIDE, NJ 07712-3305
(732) 493-4860
(732) 493-4860
Mailing address
3 PILGRIM HOLLOW RD., WAYSIDE, NJ 07712-3305
(732) 493-4860
(732) 493-4862
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MA02983700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0474908
—
NJ
Enumeration date
11/13/2008
Last updated
11/14/2008
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