Provider Demographics
NPI:1730836693
Name:BRUNO, ANTHONY ROBERT (CCSP)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:ROBERT
Last Name:BRUNO
Suffix:
Gender:M
Credentials:CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2206 W 15TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-4510
Mailing Address - Country:US
Mailing Address - Phone:814-836-8836
Mailing Address - Fax:814-835-8175
Practice Address - Street 1:INTERIM HEALTHCARE
Practice Address - Street 2:1111 VAN VOORHIS ROAD, SUITE 2
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505
Practice Address - Country:US
Practice Address - Phone:304-598-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-09
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide