# THREE VILLAGE NEUROPHYSIOLOGY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861627077
- **Authorized official:** DR. JAMES BRUNO M.D. (PRESIDENT)
- **Authorized official phone:** (631) 521-4137

## Contact information

- **Practice address:** 5 ALILAH CT, MILLER PLACE, NY 11764-1902
- **Practice address phone:** (631) 521-4137
- **Mailing address:** 5 ALILAH CT, MILLER PLACE, NY 11764-1902

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 234763 | NY | Yes |

## Other

- **Enumeration date:** 05/18/2009
- **Last updated:** 05/18/2009