MEDICARE: MICHAEL BRUCE FIRST MD

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	2084P0800X	Psychiatry Physician	158582	NY

General Provider Information

NPI Number	:	1689759250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL BRUCE FIRST MD

Provider Business Mailing Address
First Line	:	1051 RIVERSIDE DR
Second Line	:	UNIT 60
City	:	NEW YORK
State	:	NY
Zip	:	10032-1007
Country	:	US
Telephone Number	:	646-774-7935
Fax Number	:	646-774-7933

Provider Business Practice Location Address
First Line	:	1051 RIVERSIDE DR
Second Line	:	UNIT 60
City	:	NEW YORK
State	:	NY
Zip	:	10032-1007
Country	:	US
Telephone Number	:	646-774-7935
Fax Number	:	646-774-7933

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

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	12/03/2014

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