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General NPI Number Information
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NPI Number | 1073685673
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Entity Type | Individual
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Provider Name | STEPHEN ANTHONY BRUNE D.C.
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Gender | Male
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 201 WARD ST SUITE F
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City | MONTGOMERY
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State | NY
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Zip | 12549-1248
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Country | US
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Telephone | 845-457-1880
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Fax | 845-457-1887
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Provider Business Mailing Address
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Address Line | PO BOX 775
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City | PINE BUSH
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State | NY
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Zip | 12566-0775
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Country | US
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Telephone | 845-744-5607
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number | X009093
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License Number State | NY
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