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NPI Code Detail

MEDICARE: MR. MARTIN D BRUNER LCSW

MEDICARE:  MR. MARTIN D BRUNER  LCSW
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
11041C0700XClinical Social Worker072671NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790712289
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARTIN D BRUNER LCSW
Provider Business Mailing Address
First Line : 592 ROCKAWAY AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11212-5539
Country : US
Telephone Number : 718-345-5000
Fax Number : 718-345-5794
Provider Business Practice Location Address
First Line : 259 BRISTOL ST FL 3
Second Line :
City : BROOKLYN
State : NY
Zip : 11212-5540
Country : US
Telephone Number : 718-345-5000
Fax Number : 718-732-2548
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2006
Last Update Date : 08/18/2021

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Directions to “ MR. MARTIN D BRUNER LCSW” Practice Location

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