MEDICARE: JAMES L 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	207RP1001X	Pulmonary Disease Physician	185896	NY

General Provider Information

NPI Number	:	1780673244
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES L BRUNO MD

Provider Business Mailing Address
First Line	:	277 NELSON AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10308-3204
Country	:	US
Telephone Number	:	718-608-9600
Fax Number	:	718-608-9137

Provider Business Practice Location Address
First Line	:	277 NELSON AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10308-3204
Country	:	US
Telephone Number	:	718-608-9600
Fax Number	:	718-608-9137

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

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	12/21/2011

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