Harry Bruley
Individual provider Active NPI General Practice Physician · Hazleton, PA
NPI 1346357563 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1346357563
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- OS003299L (PA)
- Practice address
- 991 E Chestnut St
Hazleton, PA 18201 - Phone
- (570) 454-8980
- Fax
- (570) 454-0722
- NPI assigned
- Aug 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS003299L | PA | MD | General Practice Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | OS003299L | PA | Yes |
Addresses
Primary practice location
991 E Chestnut St
Hazleton, PA 18201
Mailing address
991 E Chestnut St
Hazleton, PA 18201
Phone (570) 454-8980
Other providers in Hazleton, PA
- Avrene Laura Brandt
- Gerald A Brazzo
- John Brennan
- Daniel John Breznak
- Jason Clair Brown
- Pamela Brune
- Hameed Ahmad Butt
- James Francis Caggiano
- Michael Thomas Cannizzaro
- John William Capparell
All providers in Hazleton, PA · General Practice Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.