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General NPI Number Information
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NPI Number | 1407706757
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Entity Type | Individual
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Provider Name | PHILIP F BRUNNER
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Gender | Male
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Dates
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Enumeration Date | 01/28/2026
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 2790 DELAWARE AVE
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City | KENMORE
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State | NY
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Zip | 14217-2704
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Country | US
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Telephone | 716-931-9037
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Fax |
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Provider Business Mailing Address
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Address Line | 252 NORWOOD AVE
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City | BUFFALO
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State | NY
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Zip | 14222-1710
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Country | US
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Telephone | 716-253-9354
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 129501-01
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License Number State | NY
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