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General NPI Number Information
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NPI Number | 1336539519
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Entity Type | Individual
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Provider Name | ROSEMARIE BRUNO LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/27/2015
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Last Update Date | 07/23/2018
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Provider Practice Location Address
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Address Line | 3771 NESCONSET HWY STE 102A
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City | SOUTH SETAUKET
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State | NY
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Zip | 11720
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Country | US
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Telephone | 631-961-8836
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Fax | 631-961-8805
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Provider Business Mailing Address
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Address Line | 3771 NESCONSET HWY STE 102A
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City | SOUTH SETAUKET
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State | NY
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Zip | 11720-1155
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Country | US
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Telephone | 631-961-8836
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Fax | 631-961-8805
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 087162
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License Number State | NY
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