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General NPI Number Information
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NPI Number | 1972810273
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Entity Type | Individual
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Provider Name | SERGIANA BRUNO LICENSED MESSAGE THE
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Gender | Female
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Dates
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Enumeration Date | 09/08/2010
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Last Update Date | 09/08/2010
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Provider Practice Location Address
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Address Line | 152 EAST AVE 2ND FLOOR
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City | NORWALK
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State | CT
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Zip | 06851
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Country | US
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Telephone | 203-550-3742
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Fax |
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Provider Business Mailing Address
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Address Line | 7 DUBOIS STREET
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City | STAMFORD
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State | CT
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Zip | 06905
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Country | US
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Telephone | 203-550-3742
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Fax | 203-428-6474
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 005886
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License Number State | CT
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