Individual
MRS. JENNIFER BRUTUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
4422 3RD AVE, BRONX, NY 10457-2545
(718) 960-9000
Mailing address
1455 PRINCE ST, NORTH BALDWIN, NY 11510-2028
(516) 314-3279
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
009222-1
NY
363AM0700X
Medical Physician Assistant
0092221
NY
Other
Enumeration date
07/26/2011
Last updated
07/26/2011
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