=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659028140
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIA A BRUNO OTR/L
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/04/2022
-----------------------------------------------------
Last Update Date | 09/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6723 TOWPATH RD
-----------------------------------------------------
City | EAST SYRACUSE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13057-9506
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-425-1004
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3262 COBB HILL RD
-----------------------------------------------------
City | CAZENOVIA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13035-9620
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-379-8474
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 026606
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------