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General NPI Number Information
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NPI Number | 1639535594
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Entity Type | Individual
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Provider Name | PATRICK BRUNNER M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/07/2016
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Last Update Date | 08/02/2021
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Provider Practice Location Address
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Address Line | 1230 YORK AVE THE ROCKEFELLER UNIVERSITY HOSPITAL
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City | NEW YORK
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State | NY
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Zip | 10065-6307
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Country | US
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Telephone | 212-327-8091
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Fax |
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Provider Business Mailing Address
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Address Line | 5 E 98TH ST FL 5
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City | NEW YORK
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State | NY
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Zip | 10029-6501
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Country | US
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Telephone | 917-244-1085
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 290252-01
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License Number State | NY
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