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General NPI Number Information
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NPI Number | 1902008238
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Entity Type | Individual
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Provider Name | MS. ELLEN BRUNETTI
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Gender | Female
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 04/26/2017
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Provider Practice Location Address
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Address Line | 200 E ECKERSON RD
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City | NEW CITY
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State | NY
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Zip | 10956-7153
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Country | US
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Telephone | 845-352-6936
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Fax | 845-352-3144
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Provider Business Mailing Address
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Address Line | 200 EAST ECKERSON ROAD 1-6
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City | NEW CITY
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State | NY
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Zip | 10956-7153
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Country | US
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Telephone | 845-352-5900
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Fax | 845-352-1142
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 333535
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License Number State | NY
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