Individual
EDWARD GERARD DI BRUNO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
3130 S 13TH ST, PHILADELPHIA, PA 19148-5235
(267) 973-2649
Mailing address
3130 S 13TH ST, PHILADELPHIA, PA 19148-5235
(267) 973-2649
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN288712L
PA
Other
Enumeration date
11/11/2009
Last updated
11/11/2009
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