| Eddy S. Bruno, M.d., Llc | |
|
920 W Market St Ste 310 Lima OH 45805-2777 | |
| (419) 225-8808 | |
| (419) 222-7220 |
| Full Name | Eddy S. Bruno, M.d., Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 920 W Market St Ste 310, Lima, Ohio |
| Authorized Official Name and Position | Eddy Severe Bruno (OWNER) |
| Authorized Official Contact | 4192258808 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eddy S. Bruno, M.d., Llc Po Box 217 Lima OH 45802-0217 Ph: (419) 225-8808 | Eddy S. Bruno, M.d., Llc 920 W Market St Ste 310 Lima OH 45805-2777 Ph: (419) 225-8808 |
| NPI Number | 1952334609 |
|---|---|
| Provider Enumeration Date | 07/08/2006 |
| Last Update Date | 06/26/2024 |
| Certification Date | 06/26/2024 |
| Medicare PECOS PAC ID | 9436166469 |
|---|---|
| Medicare Enrollment ID | O20060315000444 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952334609 | NPI | - | NPPES |
| 2582709 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 35082630 (Ohio) | Primary |
| Provider Name | Eddy S Bruno |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427080530 PECOS PAC ID: 0749264786 Enrollment ID: I20040616000948 |
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