Provider Demographics
NPI:1679191860
Name:BRUNO, BENEDETTO (MD)
Entity Type:Individual
Prefix:DR
First Name:BENEDETTO
Middle Name:
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 1:240 E 38TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2708
Mailing Address - Country:US
Mailing Address - Phone:646-501-4818
Mailing Address - Fax:929-455-9087
Practice Address - Street 1:240 E 38TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2708
Practice Address - Country:US
Practice Address - Phone:646-501-4818
Practice Address - Fax:929-455-9087
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-14
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY303804207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology