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NPI Code Detail

MEDICARE: BRUNO S FANG MD

MEDICARE: BRUNO S FANG MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RH0003XHematology & Oncology Physician25MA07087400NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11790396281OTHERNJTITAN HEALTH GROUP NPI#
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982692851
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRUNO S FANG MD
Provider Business Mailing Address
First Line : 629 CRANBURY RD FL 2
Second Line :
City : EAST BRUNSWICK
State : NJ
Zip : 08816-4096
Country : US
Telephone Number : 732-390-7750
Fax Number : 732-390-7725
Provider Business Practice Location Address
First Line : 629 CRANBURY RD FL 2
Second Line :
City : EAST BRUNSWICK
State : NJ
Zip : 08816-4096
Country : US
Telephone Number : 732-390-7750
Fax Number : 732-390-7725
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2005
Last Update Date : 05/20/2023

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Directions to “ BRUNO S FANG MD” Practice Location

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