Provider Demographics
NPI:1720484009
Name:LAWRENCE P. BRUNO, M.D., INC.
Entity Type:Organization
Organization Name:LAWRENCE P. BRUNO, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:BRUNO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-826-0770
Mailing Address - Street 1:19250 BAGLEY RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3347
Mailing Address - Country:US
Mailing Address - Phone:440-826-0770
Mailing Address - Fax:
Practice Address - Street 1:19250 BAGLEY RD
Practice Address - Street 2:SUITE 105
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3347
Practice Address - Country:US
Practice Address - Phone:440-826-0770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-13
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty