SearchNew York2255A2300X

Justin Bruckner, LAT, ATC

NPI 1225545411 · on the registry since 2018

Practice

Address
777 Pine Ave
West Islip, NY 11795
Phone
(631) 456-1779

Registry record

Primary taxonomy
2255A2300X
2255A2300X
Also registered as
390200000X
Licence states on file
PA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2021-09-21

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York