Provider Demographics
NPI:1366811358
Name:BRUSCH, CAREN (RN)
Entity type:Individual
Prefix:MS
First Name:CAREN
Middle Name:
Last Name:BRUSCH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 SOUNDVIEW AVE APT 3D
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10472-6068
Mailing Address - Country:US
Mailing Address - Phone:646-330-7861
Mailing Address - Fax:
Practice Address - Street 1:232 E 169TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-1795
Practice Address - Country:US
Practice Address - Phone:718-542-8080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-19
Last Update Date:2015-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY691706163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse