Healthcare Provider Details

I. General information

NPI: 1053335091
Provider Name (Legal Business Name): BRUCE HIGGINS RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 MADISON ST
NEW YORK NY
10002-7537
US

IV. Provider business mailing address

710 COTTAGE ST
UNIONDALE NY
11553-2917
US

V. Phone/Fax

Practice location:
  • Phone: 212-238-7461
  • Fax:
Mailing address:
  • Phone: 516-414-3566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number001800
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: