Provider Demographics
NPI:1952686156
Name:BRUSKI, DANYEL (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DANYEL
Middle Name:
Last Name:BRUSKI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 FREMONT ST STE 111
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-3395
Mailing Address - Country:US
Mailing Address - Phone:692-245-8646
Mailing Address - Fax:269-245-8648
Practice Address - Street 1:363 FREMONT ST STE 111
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-3395
Practice Address - Country:US
Practice Address - Phone:269-245-8646
Practice Address - Fax:269-245-8648
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302030242183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist