Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Justin Adam Bruckner, LAT, ATC

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1225545411

Justin Adam Bruckner, LAT, ATC is a Student in an Organized Health Care Education/Training Program in West Islip, New York. Licensed in Pennsylvania. Registered with an NPI since 2018.

Licensed in
PA
In the registry since
2018
Specialties on file
2
What do these letters mean?
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

West Islip, NY

No coordinates on file. Search this address in Google Maps

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence RTO000506 (PA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1225545411
Entity typeIndividual (Type 1)
GenderMale
Credentials LAT , ATC
Sole proprietorNo
NPI enumeratedJanuary 9, 2018
Last updated in NPPESSeptember 21, 2021
Certification dateSeptember 21, 2021

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