Provider Demographics
NPI:1447213228
Name:BRUNO, RAYMOND (DO)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:
Last Name:BRUNO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MORGAN HWY
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18508-2641
Mailing Address - Country:US
Mailing Address - Phone:570-344-3788
Mailing Address - Fax:570-969-9280
Practice Address - Street 1:3400 BATH PIKE
Practice Address - Street 2:SUITE 400
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-2466
Practice Address - Country:US
Practice Address - Phone:610-954-9400
Practice Address - Fax:610-954-0333
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS005524L225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4499269OtherAETNA
PA20049224OtherAMERIHEALTH
PABK471156OtherHIGHMARK BLUE SHIELD
PAP00341150OtherRAILROAD MEDICARE
PA0022571000OtherKEYSTONE EAST
PA41672-1067OtherGEISINGER
PA819779OtherBLUE CARE (FIRST PRIORITY
PA0022571000OtherKEYSTONE EAST