Doctor Name: | DR. BRUCE WILLIAM SURACE |
NPI Number: | 1407843444 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DC |
License Number: | X005240 |
Business Practice Address: | 59 Middle Country Rd Middle Island, NY - 119532502 |
Business Phone Number: | 6317321615 |
Business Fax Number: | 6317321612 |
Mailing Address: | 59 Middle Country Rd, MIDDLE ISLAND |
State: | NY |
Postal Code: | 119532502 |
Phone Number: | 6317321615 |
Fax Number: | 6317321612 |
NPI Enumeration Date: | 10/04/2005 |
NPI Last Update Date: | 12/06/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | X005240 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |