Provider Demographics
NPI:1326184698
Name:BRUNI-STEVENS, VITTORIA J
Entity Type:Individual
Prefix:MRS
First Name:VITTORIA
Middle Name:J
Last Name:BRUNI-STEVENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TORRI
Other - Middle Name:J
Other - Last Name:BRUNI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:329 MAIN RD
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04410-3320
Mailing Address - Country:US
Mailing Address - Phone:207-327-1317
Mailing Address - Fax:
Practice Address - Street 1:329 MAIN RD
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:ME
Practice Address - Zip Code:04410-3320
Practice Address - Country:US
Practice Address - Phone:207-327-1317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization