Individual
MS. MICHELLE M WRUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1152 MONTAUK HWY, WATER MILL, NY 11976-2635
(631) 726-8033
(631) 726-8031
Mailing address
8 DREW DR, EASTPORT, NY 11941-1335
(631) 325-8031
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F380554-1
NY
Other
Enumeration date
04/06/2007
Last updated
07/08/2007
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