Provider Demographics
NPI:1841431053
Name:BRUNO, JACLYN F (PA)
Entity Type:Individual
Prefix:MISS
First Name:JACLYN
Middle Name:F
Last Name:BRUNO
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Gender:F
Credentials:PA
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Mailing Address - Street 1:95 GRASSLANDS RD
Mailing Address - Street 2:MUNGER PAVILION DEPT SURGERY
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1652
Mailing Address - Country:US
Mailing Address - Phone:914-493-7621
Mailing Address - Fax:914-594-4359
Practice Address - Street 1:95 GRASSLANDS RD
Practice Address - Street 2:MUNGER PAVILION DEPT SURGERY
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1652
Practice Address - Country:US
Practice Address - Phone:914-493-7621
Practice Address - Fax:914-594-4359
Is Sole Proprietor?:No
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
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Provider Licenses
StateLicense IDTaxonomies
NY012292363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical