Provider Demographics
NPI:1679554257
Name:BRUNO, NANCY SMITH (AUD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:SMITH
Last Name:BRUNO
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:282 WASHINGTON ST
Mailing Address - Street 2:SUITE 2F - AUDIOLOGY
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-3322
Mailing Address - Country:US
Mailing Address - Phone:860-545-8145
Mailing Address - Fax:860-545-9662
Practice Address - Street 1:282 WASHINGTON ST
Practice Address - Street 2:SUITE 2F - AUDIOLOGY
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-3322
Practice Address - Country:US
Practice Address - Phone:860-545-8145
Practice Address - Fax:860-545-9662
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000217231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist