Provider Demographics
NPI:1497022107
Name:BRUNO, DANIELLE (NP)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:
Last Name:BRUNO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:ROSSANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:824 OLD COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-4950
Mailing Address - Country:US
Mailing Address - Phone:516-822-2230
Mailing Address - Fax:516-822-0163
Practice Address - Street 1:824 OLD COUNTRY RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803
Practice Address - Country:US
Practice Address - Phone:516-822-2230
Practice Address - Fax:516-822-0163
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-23
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY627032163W00000X
NYF308250-1363LG0600X, 363LP2300X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care