Organization Name: | OCCUPATIONAL HEALTH SERVICES RPN NP ADULT HEALTH PLLC |
NPI Number: | 1407040280 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GWEN ELIZABETH BRUNO (MANAGER) |
Mailing Address: | 187-189 Center Street Salamanca |
State: | NY US |
Postal Code: | 147791454 |
Phone Number: | 7169452825 |
Fax Number: | 7169452827 |
NPI Enumeration Date: | 09/05/2007 |
NPI Last Update Date: | 06/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | F303946 1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |