Healthcare Provider Details

I. General information

NPI: 1689636342
Provider Name (Legal Business Name): MARIA A BRUNO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7718 ROUTE 30 EAST
NORTH HUNTINGTON PA
15642
US

IV. Provider business mailing address

7718 ROUTE 30 EAST
NORTH HUNTINGTON PA
15642
US

V. Phone/Fax

Practice location:
  • Phone: 724-864-4850
  • Fax: 724-861-5808
Mailing address:
  • Phone: 724-864-4850
  • Fax: 724-861-5808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD036879L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: