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General NPI Number Information
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NPI Number | 1235963133
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Entity Type | Individual
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Provider Name | VICTORIA MARTEL BRUNO FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/02/2024
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Last Update Date | 09/02/2024
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Provider Practice Location Address
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Address Line | 258 SAINT NICHOLAS AVE
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City | NEW YORK
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State | NY
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Zip | 10027-5351
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Country | US
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Telephone | 212-222-0075
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Fax |
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Provider Business Mailing Address
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Address Line | 76 W 85TH ST APT 5E
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City | NEW YORK
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State | NY
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Zip | 10024-4519
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Country | US
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Telephone | 203-451-5569
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F354189-01
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License Number State | NY
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