MEDICARE: DOROTHY BRUNO

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	164W00000X	Licensed Practical Nurse	356103	NY

General Provider Information

NPI Number	:	1710821004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOROTHY BRUNO

Provider Business Mailing Address
First Line	:	4200 AVENUE K APT 1J
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-4913
Country	:	US
Telephone Number	:	646-207-8196
Fax Number	:

Provider Business Practice Location Address
First Line	:	6424 18TH AVE FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-3729
Country	:	US
Telephone Number	:	212-687-7464
Fax Number	:

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

Provider Enumeration Date	:	04/16/2026
Last Update Date	:	04/16/2026

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Directions to “ DOROTHY BRUNO ” Practice Location

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