Jaclyn Bruno, OD | |
33 W 42nd St, New York, NY 10036-8005 | |
(732) 938-4001 | |
Not Available |
Full Name | Jaclyn Bruno |
---|---|
Gender | Female |
Speciality | Optometrist |
Location | 33 W 42nd St, New York, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1073800587 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | TUV007696 (New York) | Primary |
Provider Name | Montefiore Medical Center |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1063525152 PECOS PAC ID: 3779496021 Enrollment ID: O20031113000235 |
Mailing Address | Practice Location Address |
---|---|
Jaclyn Bruno, OD 4719 28th Ave # 1, Astoria, NY 11103-1116 Ph: (732) 688-4729 | Jaclyn Bruno, OD 33 W 42nd St, New York, NY 10036-8005 Ph: (732) 938-4001 |
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