Doctor Name: | DR. THOMAS T BRUNOSKI |
NPI Number: | 1609097880 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 021778 |
Business Practice Address: | 4 Ivy Knoll Westport, CT - 068802326 |
Business Phone Number: | 2034545963 |
Business Fax Number: | |
Mailing Address: | 4 Ivy Knoll, WESTPORT |
State: | CT |
Postal Code: | 068802326 |
Phone Number: | 2034545963 |
Fax Number: | |
NPI Enumeration Date: | 05/02/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 021778 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |