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General NPI Number Information
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NPI Number | 1891686838
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Entity Type | Individual
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Provider Name | BARTOSZ ANTONI BUGNO
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Gender |
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Dates
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Enumeration Date | 07/09/2025
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 201 N MAYFAIR RD
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City | WAUWATOSA
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State | WI
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Zip | 53226-4216
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Country | US
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Telephone | 414-259-7292
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Fax |
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Provider Business Mailing Address
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Address Line | W240N2578 E PARKWAY MEADOW CIR UNIT 6
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City | PEWAUKEE
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State | WI
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Zip | 53072-5838
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Country | US
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Telephone | 262-271-5730
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 4036-19
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License Number State | WI
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