Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 000960 | CT |
NPI | 1083033666 |
---|---|
Provider Name | Dr. Ashley Anne Bruno |
First Address | Bethel Park, PA 15102-3450 |
Second Address | West Haven, CT 06516-2770 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2014 |
Last Update Date | 30/06/2017 |