MEDICARE: ANTHONY M BRUNO MD

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
1	208800000X	Urology Physician	110465	NY

General Provider Information

NPI Number	:	1225094980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY M BRUNO MD

Provider Business Mailing Address
First Line	:	1305 FRANKLIN AVE
Second Line	:	SUITE 100
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-1657
Country	:	US
Telephone Number	:	516-746-5550
Fax Number	:	516-746-9641

Provider Business Practice Location Address
First Line	:	1305 FRANKLIN AVE
Second Line	:	SUITE 100
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-1657
Country	:	US
Telephone Number	:	516-746-5550
Fax Number	:	516-746-9641

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2006
Last Update Date	:	12/31/2007

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