Individual
NICHOLAS PAUL BRUNO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3 WAKE ROBIN RD UNIT 5, LINCOLN, RI 02865-4208
(401) 475-9140
(401) 475-2808
Mailing address
741 SMITH STREET, PROVIDENCE, RI 02908-3592
(401) 421-7656
(401) 270-6457
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
5860
RI
207ND0900X
Dermatopathology Physician
5860
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000499
—
RI
Enumeration date
09/05/2006
Last updated
04/03/2019
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