Provider Demographics
NPI:1184408064
Name:OCUMARES, BRUNISMEL
Entity type:Individual
Prefix:
First Name:BRUNISMEL
Middle Name:
Last Name:OCUMARES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRUNISMEL
Other - Middle Name:
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:500 W 176TH ST APT 37
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-8408
Mailing Address - Country:US
Mailing Address - Phone:347-872-2586
Mailing Address - Fax:
Practice Address - Street 1:500 W 176TH ST APT 37
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-8408
Practice Address - Country:US
Practice Address - Phone:347-872-2586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator