Provider Demographics
NPI:1497938229
Name:BRUNN, STEVEN HOWARD (RPH)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:HOWARD
Last Name:BRUNN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3823 NOSTRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2012
Mailing Address - Country:US
Mailing Address - Phone:718-743-8933
Mailing Address - Fax:718-332-2381
Practice Address - Street 1:3823 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2012
Practice Address - Country:US
Practice Address - Phone:718-743-8933
Practice Address - Fax:718-332-2381
Is Sole Proprietor?:No
Enumeration Date:2007-12-15
Last Update Date:2007-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045521183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist