| Organization Name: | DR. BRUCE DORMAN, D.P.M. |
| NPI Number: | 1720261274 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRUCE A DORMAN (OWNER) |
| Mailing Address: | 6134 188th St Suite 203 Fresh Meadows |
| State: | NY US |
| Postal Code: | 113652726 |
| Phone Number: | 7184544333 |
| Fax Number: | 7184544823 |
| NPI Enumeration Date: | 12/06/2007 |
| NPI Last Update Date: | 01/18/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | NY003551 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |