Healthcare Provider Details

I. General information

NPI: 1821784323
Provider Name (Legal Business Name): ALICE BUKRINSKY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2023
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 ROE AVE
ELMIRA NY
14905-1676
US

IV. Provider business mailing address

600 ROE AVE
ELMIRA NY
14905-1676
US

V. Phone/Fax

Practice location:
  • Phone: 607-737-4100
  • Fax:
Mailing address:
  • Phone: 315-801-8534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: