Bruckner, Justin Adam

Bruckner, Justin Adam is an individual health care provider with primary practice located at 777 Pine Ave , West Islip NY 11795-2707. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer is his primary health care specialty. Bruckner, Justin Adam can be contacted via phone (631) 456-1779.

Contact Information

Primary practice address
777 Pine Ave West Islip NY 11795-2707
Phone: (631) 456-1779
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X RTO000506 Pennsylvania

Profile Details

NPI number 1225545411
LBN Legal business name Bruckner, Justin Adam
Credentials LAT, ATC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2018
Last updated Sep 21st, 2021 - about 5 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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