Provider Demographics
NPI:1053673889
Name:BRUZZESE, RONALD (MSED,)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:
Last Name:BRUZZESE
Suffix:
Gender:M
Credentials:MSED,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 MONTEREY LN
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-4517
Mailing Address - Country:US
Mailing Address - Phone:732-688-9144
Mailing Address - Fax:
Practice Address - Street 1:13 MONTEREY LN
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-4517
Practice Address - Country:US
Practice Address - Phone:732-688-9144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist