Provider Demographics
NPI:1356388052
Name:PESTANA, J. BRUNO (MD)
Entity type:Individual
Prefix:
First Name:J. BRUNO
Middle Name:
Last Name:PESTANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:795 MIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-1733
Mailing Address - Country:US
Mailing Address - Phone:508-235-5226
Mailing Address - Fax:
Practice Address - Street 1:795 MIDDLE STREET
Practice Address - Street 2:ST. ANNE'S HOSPITAL
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-1798
Practice Address - Country:US
Practice Address - Phone:508-235-5226
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA46436207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology