Individual
DR. BRUNO MANDUCA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
184 HOLDEN BLVD, STATEN ISLAND, NY 10314-5159
(718) 815-0710
(718) 761-0711
Mailing address
184 HOLDEN BLVD, STATEN ISLAND, NY 10314-5159
(718) 815-0710
(718) 761-0711
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
201385
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01613872
—
NY
Enumeration date
07/09/2006
Last updated
11/12/2007
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