Provider Demographics
NPI:1235963133
Name:BRUNO, VICTORIA MARTEL (FNP-BC)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:MARTEL
Last Name:BRUNO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 W 85TH ST APT 5E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-4519
Mailing Address - Country:US
Mailing Address - Phone:203-451-5569
Mailing Address - Fax:
Practice Address - Street 1:258 SAINT NICHOLAS AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-5351
Practice Address - Country:US
Practice Address - Phone:212-222-0075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-02
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF354189-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily