Healthcare Provider Details

I. General information

NPI: 1710516018
Provider Name (Legal Business Name): GABRIELLE ANN BRUZDA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2020
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 AMHERST ST
WINCHESTER VA
22601-2808
US

IV. Provider business mailing address

1840 AMHERST ST
WINCHESTER VA
22601-2808
US

V. Phone/Fax

Practice location:
  • Phone: 724-961-5337
  • Fax: 724-671-9689
Mailing address:
  • Phone: 724-961-5337
  • Fax: 724-671-9689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0102206883
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: