Provider Demographics
NPI:1215178447
Name:BRUNO, LINDSEY SHAW
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:SHAW
Last Name:BRUNO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 ROXBURY CT
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-1511
Mailing Address - Country:US
Mailing Address - Phone:203-271-3288
Mailing Address - Fax:203-730-0880
Practice Address - Street 1:46 ROXBURY CT
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-1511
Practice Address - Country:US
Practice Address - Phone:203-271-3288
Practice Address - Fax:203-730-0880
Is Sole Proprietor?:No
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3425225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics