Organization
SLRCH FACULTY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BRUNO (VP)
(212) 523-7140
Entity
Organization
Contact information
Practice address
425 W 59TH ST, SUITE 7A, NEW YORK, NY 10019-8022
(212) 523-7500
Mailing address
PO BOX 95000-2230, PHILADELPHIA, PA 19195-0001
(212) 523-7500
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
04/30/2009
Last updated
04/30/2009
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