Provider Demographics
NPI:1013137058
Name:BRUSCO, CRISTINA M I (MD)
Entity Type:Individual
Prefix:DR
First Name:CRISTINA
Middle Name:M
Last Name:BRUSCO
Suffix:I
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 GREENFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-2501
Mailing Address - Country:US
Mailing Address - Phone:914-771-8056
Mailing Address - Fax:914-771-8056
Practice Address - Street 1:21 GREENFIELD AVE
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-2501
Practice Address - Country:US
Practice Address - Phone:914-771-8056
Practice Address - Fax:914-771-8056
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYBB94807642084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine