Robert Thomas Bruzzese, L.I.C.S.W.

Primary specialty

Social WorkerTaxonomy code 104100000X

License

101048 Issued in MA

Practice address

589 Broadway
Apt. D
Revere, MA 02151

Phone

(508) 330-1053

NPI assigned

Oct 2, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578656252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "589 BROADWAY",
            "address_2": "APT. D",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "02151",
            "telephone_number": "508-330-1053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "589 BROADWAY",
            "address_2": "APT. D",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "02151",
            "telephone_number": "508-330-1053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUZZESE",
        "first_name": "ROBERT",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "101048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Broadway Physical Therapy, Inc.
• Carol Broder
• Johane Brown, RN, FNP
• John Timothy Brown II, PHARMD
• Melissa Brown
• Jessica Bryski
• Drew Bunker
• Alannah Rose Burke
• Jessica E Burke, LMHC
• Susan Curley Burton, MSED

• Social Worker in Revere, MA
• Providers in Revere, MA by specialty
• Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.