Provider Demographics
NPI:1265972061
Name:BRUNO PLASTIC SURGERY, PC
Entity type:Organization
Organization Name:BRUNO PLASTIC SURGERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:D
Authorized Official - Last Name:BRUNO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-299-0856
Mailing Address - Street 1:50 GLENMAURA NATIONAL BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MOOSIC
Mailing Address - State:PA
Mailing Address - Zip Code:18507-2124
Mailing Address - Country:US
Mailing Address - Phone:570-299-0856
Mailing Address - Fax:
Practice Address - Street 1:50 GLENMAURA NATIONAL BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:MOOSIC
Practice Address - State:PA
Practice Address - Zip Code:18507-2124
Practice Address - Country:US
Practice Address - Phone:570-299-0856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty