Mark Nelson Brueckl, R.PH., MBA

Primary specialty

PharmacistTaxonomy code 183500000X

License

0202207378 Issued in VA

Practice address

100 N Pitt St
Suite 400
Alexandria, VA 22314-3134

Phone

(703) 683-8416

Fax

(703) 683-8417

NPI assigned

May 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Business Administration, Registered Pharmacist

State licenses

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316997935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 COLLINS CT",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225566551",
            "telephone_number": "540-288-0792",
            "fax_number": "703-683-8417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N PITT ST",
            "address_2": "SUITE 400",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223143134",
            "telephone_number": "703-683-8416",
            "fax_number": "703-683-8417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUECKL",
        "first_name": "MARK",
        "middle_name": "NELSON",
        "name_prefix": "Mr.",
        "credential": "R.PH., MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "030718",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202207378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cynthia Griffin Brucato, LCSW
• Nicole Brugel
• Brittany Brugos, CRNA
• Althea Veronique Brumskine
• Sofia Shahid Brundage
• Tiffany Kristina Brundidge, COTA/L

• Pharmacist in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Pharmacist in Virginia

• 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.

Verify at the official NPI Registry.