Provider Demographics
NPI:1760135040
Name:BRAUNSTEIN, BRUCE I (CCP)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:I
Last Name:BRAUNSTEIN
Suffix:
Gender:M
Credentials:CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8370 SPLIT ROCK TRL
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-3925
Mailing Address - Country:US
Mailing Address - Phone:669-454-6472
Mailing Address - Fax:
Practice Address - Street 1:197 W ALMA AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95110-3632
Practice Address - Country:US
Practice Address - Phone:669-454-6472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist