| Doctor Name: | MRS. MARIANNE TERESA BRUYERE |
| NPI Number: | 1114243318 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 490645 |
| Business Practice Address: | 1 Chimney Point Dr Ogdensburg, NY - 136692212 |
| Business Phone Number: | 3155412001 |
| Business Fax Number: | 3155412089 |
| Mailing Address: | 1 Chimney Point Dr, OGDENSBURG |
| State: | NY |
| Postal Code: | 136692212 |
| Phone Number: | 3155412001 |
| Fax Number: | 3155412089 |
| NPI Enumeration Date: | 04/13/2010 |
| NPI Last Update Date: | 04/13/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0807X |
| License Number: | 490645 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health, Child & Adolescent |
| Taxonomy Definition: | |