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NPI Code Detail

MEDICARE: MS. DIANNA MARIE BRUZZONE

MEDICARE:  MS. DIANNA MARIE BRUZZONE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist046284-1NY

General Provider Information

NPI Number : 1114177763
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DIANNA MARIE BRUZZONE
Provider Business Mailing Address
First Line : 166 ASHBROOK CIR
Second Line :
City : WEBSTER
State : NY
Zip : 14580-8588
Country : US
Telephone Number : 585-545-4345
Fax Number :
Provider Business Practice Location Address
First Line : 2100 MONROE AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14618-2408
Country : US
Telephone Number : 585-461-3995
Fax Number : 585-241-9092
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2008
Last Update Date : 09/19/2008

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Directions to “ MS. DIANNA MARIE BRUZZONE ” Practice Location

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