Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 097574-1 | NY |
NPI | 1215050273 |
---|---|
Provider Name | Dr. Bruno Recupero |
First Address | New York, NY 10009-7601 |
Second Address | New York, NY 10009-7601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2007 |
Last Update Date | 17/12/2012 |