Gary Bruschi, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

007179 Issued in NY

Practice address

10 Grace Ave
Suite 12 D
Great Neck, NY 11021-2423

Phone

(515) 773-3607

NPI assigned

Jan 30, 2009

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1233273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233273600000",
    "number": "1265670194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 CENTRAL PARK W",
            "address_2": "APT. 11 L",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256054",
            "telephone_number": "212-769-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 GRACE AVE",
            "address_2": "SUITE 12 D",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212423",
            "telephone_number": "515-773-3607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUSCHI",
        "first_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-30",
        "last_updated": "2009-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "007179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Great Neck, NY
• Providers in Great Neck, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.