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1881299352
DAVID BRUCE JACK
NEW YORK, NY
NPI
1881299352
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NY 025760)
Enumeration Date
2020-12-02
Last Update Date
2020-12-02
Business Address
DAVID BRUCE JACK PA
281 1ST AVE
NEW YORK, NY 10003-2925
Phone number: 212-420-2000
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Mailing Address
DAVID BRUCE JACK PA
214 PINE RD
CORAM, NY 11727-2410
Phone number:
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