DR. BRUCE D MARZULLO (NPI# 1154461689) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154461689 |
| Entity Type | Individual |
| Full Name | DR. BRUCE D MARZULLO |
| Credential | DDS |
| Practice Address |
43 Lagrange Avenue Poughkeepsie NY 12603 |
| Practice Telephone | 8454522900 |
| Practice Fax Number | 8454524974 |
| Mailing Telephone | 8454522900 |
| Mailing Fax Number | 8454524974 |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
037383 | NY | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | DEA NUMBER | BM0841355 | 01 |
| NY | 01017770 | 05 |
| Street Address |
43 LAGRANGE AVENUE |
| City | POUGHKEEPSIE |
| State | NY |
| Zip Code | 12603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831712082 | Hudson Valley Radiologists, PC | Radiology | 23 Sommerset Rd, Poughkeepsie, NY 12603 | 2020-05-22 |
| 1013555812 | Jaclyn Anne Johnson | Licensed Practical Nurse | 370 Cedar Valley Rd, Poughkeepsie, NY 12603 | 2019-12-12 |
| 1790345189 | Nirja Kumar | Counselor | 514 Height Ave, Poughkeepsie, NY 12603 | 2019-06-18 |
| 1790349512 | Mariama-seray Binta Barrie | Nurse Practitioner | 50 Eastdale Avenue, Poughkeepsie, NY 12603 | 2019-04-26 |
| 1871066670 | Heather Greer Belding-wilson | Dietitian, Registered | 76 Firemen's Way, Poughkeepsie, NY 12603 | 2019-01-04 |
| 1861968927 | Cynthia Lee Specht | Registered Nurse | 488 Freedom Plains Rd Ste 122, Poughkeepsie, NY 12603 | 2018-10-16 |
| 1740772177 | Courtney W Albert, Mental Health Counseling, Pllc | Counselor | 2 - 4 Austin Court, Poughkeepsie, NY 12603 | 2018-06-01 |
| 1649797820 | Kaizen Physical Therapy P.l.l.c. | Clinic/Center | 26 Cooper Rd Apt 715, Poughkeepsie, NY 12603 | 2017-08-28 |
| 1740704998 | Kimberly Cwik | Licensed Practical Nurse | 14 Westend Avenue, Poughkeepsie, NY 12603 | 2017-07-31 |
| 1114389426 | Gina Huss | Case Manager/Care Coordinator | 6 Deer Run Rd, Poughkeepsie, NY 12603 | 2016-03-25 |
| Find all providers in zip 12603 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417051624 | Joseph M Prisco | Dentist | 29 Fox Street, Poughkeepsie, NY 12601 | 2006-09-08 |
| 1023021532 | Stanley Rudnicki | Dentist | 143 Hooker Ave, Poughkeepsie, NY 12601 | 2006-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053921643 | Upper West Side Oral & Maxillofacial Surgery | Dentist | 140 W 69th St Ph 1g, New York, NY 10023-5173 | 2020-08-07 |
| 1467092965 | Nyc Implant and Oral Surgery PC | Dentist | 30 E 60th St Ste 907, New York, NY 10022-1058 | 2020-01-13 |
| 1235777566 | Asnis Dental Pllc | Dentist | 800 Woodbury Rd Ste C, Woodbury, NY 11797-2503 | 2019-12-17 |
| 1700420429 | Chavkin Oral and Maxillofacial Surgery LLC | Dentist | 414 Jericho Tpke Ste 2, New Hyde Park, NY 11040-4510 | 2019-11-06 |
| 1730737545 | Southwoods Boulevard Dental, P.C. | Dentist | 7 Southwoods Blvd Ste 1, Albany, NY 12211-2526 | 2019-08-27 |
| 1750947792 | Eduard Munarov Dds PC | Dentist | 449 N State Rd Ste 102, Briarcliff Manor, NY 10510-1478 | 2019-05-15 |
| 1598227530 | Asnis Dental Pllc | Dentist | 250 Patchogue Yaphank Rd Ste 10, East Patchogue, NY 11772-4862 | 2019-04-01 |
| 1720545387 | Asnis Dental, Pllc | Dentist | 260 Middle Country Rd Ste 12, Selden, NY 11784-2570 | 2019-03-01 |
| 1205344819 | Ray Cheng Dds | Dentist | 217 Park Row Ste 4b, New York, NY 10038-1101 | 2018-01-17 |
| 1871006064 | Ny Oral and Maxillofacial Surgeon, PC | Dentist | 2844 Ocean Pkwy Ste B2, Brooklyn, NY 11235-7904 | 2017-11-09 |
| Find all providers with the same taxonomy | ||||
| City | POUGHKEEPSIE |
| Zip Code | 12603 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.