Provider Demographics
NPI:1215235536
Name:MAYER, BRUCHY (CERTIFIED)
Entity type:Individual
Prefix:MRS
First Name:BRUCHY
Middle Name:
Last Name:MAYER
Suffix:
Gender:F
Credentials:CERTIFIED
Other - Prefix:MRS
Other - First Name:BRUCHY
Other - Middle Name:
Other - Last Name:MAYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8 CORTLAND RD
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-1623
Mailing Address - Country:US
Mailing Address - Phone:917-776-8542
Mailing Address - Fax:845-354-5796
Practice Address - Street 1:8 CORTLAND RD
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-1623
Practice Address - Country:US
Practice Address - Phone:917-776-8542
Practice Address - Fax:845-354-5796
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY73588174H00000X
NY6961374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No374J00000XNursing Service Related ProvidersDoula