Individual
JOSEPH MARK PRUNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
56 FRANKLIN STREET, WATERBURY, CT 06706
(203) 704-1195
Mailing address
56 FRANKLIN STREET, WATERBURY, CT 06706
(203) 704-1195
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
55238
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/09/2013
Last updated
10/28/2021
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