Provider Demographics
NPI:1538113360
Name:BRUNO, LEONARD A (MD)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:A
Last Name:BRUNO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 WELSH RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-6357
Mailing Address - Country:US
Mailing Address - Phone:215-914-2320
Mailing Address - Fax:215-914-2365
Practice Address - Street 1:727 WELSH RD
Practice Address - Street 2:SUITE 108
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-6357
Practice Address - Country:US
Practice Address - Phone:215-914-2320
Practice Address - Fax:215-914-2365
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD014442E207T00000X
NY1131781207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007557400009Medicaid
PA126029Medicare ID - Type Unspecified
PA0007557400009Medicaid