Provider Demographics
NPI:1497827588
Name:SCHETTINI, BRUNO (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUNO
Middle Name:
Last Name:SCHETTINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7317 LOCHHAVEN ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18106-9128
Mailing Address - Country:US
Mailing Address - Phone:610-390-0410
Mailing Address - Fax:610-398-8846
Practice Address - Street 1:3560 OLD ROUTE 22
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:PA
Practice Address - Zip Code:19526
Practice Address - Country:US
Practice Address - Phone:610-562-6002
Practice Address - Fax:570-621-4560
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD051500L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G60465Medicare UPIN