Provider Demographics
NPI:1932454576
Name:BRUGGE, KAREN (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BRUGGE
Suffix:
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 1:3246 COUNTY ROAD 22
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14815-9616
Mailing Address - Country:US
Mailing Address - Phone:607-377-1530
Mailing Address - Fax:
Practice Address - Street 1:290 E 1ST ST
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830-2925
Practice Address - Country:US
Practice Address - Phone:301-704-9045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2013-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2703512084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry