Bruder, Jack
Bruder, Jack is an sole proprietor health care provider with primary practice located at 50 E 42Nd St Rm 508 , New York NY 10017-5436. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Bruder, Jack can be contacted via phone (212) 661-7003.Contact Information
Primary practice address
50 E 42Nd St Rm 508
New York NY 10017-5436
Phone: (212) 661-7003
Fax: (212) 661-7005
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 155544 | New York |
Profile Details
| NPI number | 1518974328 |
|---|---|
| LBN Legal business name | Bruder, Jack |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 2nd, 2006 |
| Last updated | May 9th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518974328 | NPPES |
| Other | 01156G | MEDICARE GHI | |
| Other | 0011594 | MEDICARE GHI | |
| MEDICAID | 01096693 | MEDICARE GHI | |
| Other | 113945 | MEDICARE GHI | |
| Other | 52313 | MEDICARE GHI | |
| Other | 1900573 | MEDICARE GHI | |
| Other | NS1506 | MEDICARE GHI |
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