Provider Demographics
NPI:1871785147
Name:BRUNO, SARAH-ANNE M (DC)
Entity type:Individual
Prefix:
First Name:SARAH-ANNE
Middle Name:M
Last Name:BRUNO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 GOLD STAR HWY STE 324
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-6230
Mailing Address - Country:US
Mailing Address - Phone:860-445-5000
Mailing Address - Fax:800-948-0609
Practice Address - Street 1:495 GOLD STAR HWY STE 324
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-6230
Practice Address - Country:US
Practice Address - Phone:860-445-5000
Practice Address - Fax:800-948-0609
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00519111N00000X
CT001719111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
007060040Medicare PIN