Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 254358 | NY |
NPI | 1316003221 |
---|---|
Provider Name | Bruno F Casanova |
First Address | New York, NY 10041-0004 |
Second Address | Brooklyn, NY 11217-1702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2006 |
Last Update Date | 10/09/2019 |