MEDICARE: DR. BRUCE BERNS D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	007206	NY

General Provider Information

NPI Number	:	1679664262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE BERNS D.C.

Provider Business Mailing Address
First Line	:	2805 VETERANS MEMORIAL HWY
Second Line	:	STE 8
City	:	RONKONKOMA
State	:	NY
Zip	:	11779-7680
Country	:	US
Telephone Number	:	631-667-6117
Fax Number	:	631-667-6118

Provider Business Practice Location Address
First Line	:	2805 VETERANS HWY
Second Line	:	STE 8
City	:	RONKONKOMA
State	:	NY
Zip	:	11779-7680
Country	:	US
Telephone Number	:	516-238-6799
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	10/19/2017

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