Provider Demographics
NPI:1205577525
Name:BRUNO, ERICA (OTR/L)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:BRUNO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HOFFNER CT
Mailing Address - Street 2:
Mailing Address - City:ROEBLING
Mailing Address - State:NJ
Mailing Address - Zip Code:08554-1705
Mailing Address - Country:US
Mailing Address - Phone:609-864-5780
Mailing Address - Fax:
Practice Address - Street 1:57 UNION PL STE 204
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-2568
Practice Address - Country:US
Practice Address - Phone:908-273-5537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-03
Last Update Date:2022-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01046700225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist