Individual
ATHENA MARIE BRUZZANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
928 BROADWAY STE 301, NEW YORK, NY 10010-8156
(464) 216-0646
Mailing address
215 BEACH 123RD ST, ROCKAWAY PARK, NY 11694-1828
(917) 613-7318
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
024502
NY
Other
Enumeration date
08/15/2019
Last updated
08/05/2025
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