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General NPI Number Information
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NPI Number | 1851447205
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Entity Type | Individual
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Provider Name | BRYAN JOHN BRUNO M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 03/18/2019
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Provider Practice Location Address
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Address Line | 280 MADISON AVE
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City | NEW YORK
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State | NY
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Zip | 10016
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Country | US
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Telephone | 212-717-4869
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Fax | 917-409-5405
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Provider Business Mailing Address
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Address Line | 280 MADISON AVE RM 1102
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City | NEW YORK
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State | NY
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Zip | 10016-0817
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Country | US
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Telephone | 212-717-4869
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Fax | 917-409-5405
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 203615
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License Number State | NY
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