Healthcare Provider Details

I. General information

NPI: 1508047739
Provider Name (Legal Business Name): JAMES L. BRUNO, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2007
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

277 NELSON AVE
STATEN ISLAND NY
10308-3204
US

IV. Provider business mailing address

4010 HYLAN BLVD
STATEN ISLAND NY
10308-3331
US

V. Phone/Fax

Practice location:
  • Phone: 718-608-9600
  • Fax: 718-608-9137
Mailing address:
  • Phone: 718-608-9600
  • Fax: 718-608-9137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number185896
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number185896
License Number StateNY

VIII. Authorized Official

Name: JAMES L. BRUNO
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 718-608-9600