Healthcare Provider Details

I. General information

NPI: 1497022107
Provider Name (Legal Business Name): DANIELLE BRUNO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DANIELLE ROSSANO NP

II. Dates (important events)

Enumeration Date: 11/23/2011
Last Update Date: 09/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

824 OLD COUNTRY RD
PLAINVIEW NY
11803
US

IV. Provider business mailing address

824 OLD COUNTRY RD
PLAINVIEW NY
11803-4950
US

V. Phone/Fax

Practice location:
  • Phone: 516-822-2230
  • Fax: 516-822-0163
Mailing address:
  • Phone: 516-822-2230
  • Fax: 516-822-0163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number627032
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberF308250-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberF308250-1
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF308250-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: