Active NPI
Stephanie M Bruzgul, P.A.
- Physician Assistant
- Lockport, NY
National Provider Identifier
1255369948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 010840-1
- Practice address
- 5875 S Transit Rd
Lockport, NY 14094-6340 - Phone
- (716) 433-3053
- NPI assigned
- Jun 29, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 010840-1 | NY | Primary |
Addresses
Primary practice location
5875 S Transit Rd
Lockport, NY 14094-6340
Mailing address
5875 S Transit Rd
Lockport, NY 14094-6340
Phone (716) 433-3053
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010840 | NY | MD | Physical Therapist |
| 010840-1 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1255369948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5875 S TRANSIT RD",
"city": "LOCKPORT",
"state": "NY",
"postal_code": "140946340",
"telephone_number": "716-433-3053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5875 S TRANSIT RD",
"city": "LOCKPORT",
"state": "NY",
"postal_code": "140946340",
"telephone_number": "716-433-3053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUZGUL",
"first_name": "STEPHANIE",
"middle_name": "M",
"credential": "P.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "010840-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lockport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.