Bruno, Basil

Bruno, Basil is an individual health care provider with primary practice located at 18 Railroad Ave Suite 103, Rochelle Park NJ 07662-4105. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Bruno, Basil can be contacted via phone (201) 928-0748.

Contact Information

Primary practice address
18 Railroad Ave Suite 103 Rochelle Park NJ 07662-4105
Fax: (201) 928-0842
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MA055053 New Jersey
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 270553 New York
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 25MA05505300 New Jersey

Profile Details

NPI number 1164509444
LBN Legal business name Bruno, Basil
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Aug 9th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164509444 NPPES
New Jersey MEDICAID 6029701

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