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General NPI Number Information
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NPI Number | 1902902265
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Entity Type | Organization
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Legal Business Name | ROBERT E BRUNNER INC
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 12/26/2007
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Provider Practice Location Address
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Address Line | 100 EAST BROAD STREET
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City | WESTFIELD
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State | NJ
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Zip | 07090-2112
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Country | US
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Telephone | 908-232-8182
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Fax | 908-232-5727
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Provider Business Mailing Address
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Address Line | 100 EAST BROAD STREET
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City | WESTFIELD
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State | NJ
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Zip | 07090-2112
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Country | US
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Telephone | 908-232-8182
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Fax | 908-232-5727
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Authorized Official
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Title or Position | OWNER
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Name | SUSAN AUER
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Credential | OPTICIAN
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Telephone | 908-232-8182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 31TD00078500
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License Number State | NJ
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