Provider Demographics
NPI:1669458998
Name:DICOSMO, BRUNO FRANCESCO (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUNO
Middle Name:FRANCESCO
Last Name:DICOSMO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:210 WESTCHESTER AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2901
Mailing Address - Country:US
Mailing Address - Phone:914-681-3146
Mailing Address - Fax:914-682-6403
Practice Address - Street 1:1 THEALL RD
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-1404
Practice Address - Country:US
Practice Address - Phone:914-848-8777
Practice Address - Fax:914-682-6403
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT031054207RP1001X
NY196360-1207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY015028810046Medicaid
NY000342OtherCONNECTICARE
NY133884168OtherMULTIPLAN (PUL. ONLY)
NY133884168OtherUNITED HEALTH CARE
NY436L81/2OtherBLUE CROSS
NY50491OtherGHI HMO
NYOD1657OtherHEALTH NET
NY559640OtherAETNA HMO
NY133884168OtherHIP
NYWS1056OtherOXFORD
NY133884168OtherGHI PPO
NY436L81OtherEMPIRE STATE PLAN (NYS)
NY4566679OtherAETNA NON HMO
NY1338841668OtherPOMCO
NY133884168OtherBEECH STREET
NY133884168OtherPHCS
NY1553731-009/007OtherCIGNA PCO/SPECIALTY
NY133884168OtherUNITED HEALTH CARE
NY4566679OtherAETNA NON HMO
NYE66143Medicare UPIN