Bruckstein, Robert L

Bruckstein, Robert L is an individual health care provider with primary practice located at 290 Central Ave Suite 206, Lawrence NY 11559-8507. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Bruckstein, Robert L can be contacted via phone (516) 239-2332.

Contact Information

Primary practice address
290 Central Ave Suite 206 Lawrence NY 11559-8507
Phone: (516) 239-2332
Fax: (516) 371-2251
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 117212-1 New York

Profile Details

NPI number 1386644375
LBN Legal business name Bruckstein, Robert L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2005
Last updated Nov 10th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386644375 NPPES
New York MEDICAID 00216904

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