Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Athena Marie Bruzzano, PA-C

Individual provider Physician Assistant · NPI 1942856885

Athena Marie Bruzzano, PA-C is a Physician Assistant in New York, New York. Qualified in 2019, 7 years ago. Practices with Kathleen Vine MD PC, a 10-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
7
Licensed in
NY
In the registry since
2019
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

928 Broadway Ste 301
New York, NY 10010-8156
Phone: (464) 216-0646
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 024502 (NY)

Record details

NPI number1942856885
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedAugust 15, 2019
Last updated in NPPESAugust 5, 2025
Certification dateAugust 5, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Kathleen Vine Md Pc — 10 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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