Active NPI
Kwesi Abdalla Bruno
- Physical Therapist
- Brooklyn, NY
National Provider Identifier
1669744264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 034211-1
- Practice address
- 395 Maple Street
Apt. C8
Brooklyn, NY 11225-5226 - Phone
- (718) 687-8221
- Fax
- (718) 773-1877
- NPI assigned
- Jan 30, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 034211-1 | NY | Primary |
| Physical Therapist | 225100000X | 1211571 | TX |
Addresses
Primary practice location
395 Maple Street
Apt. C8
Brooklyn, NY 11225-5226
Mailing address
395 Maple Street
Apt. C8
Brooklyn, NY 11225-5226
Phone (718) 687-8221
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 034211-1 | NY | MD | Physical Therapist |
| 1211571 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327881600000",
"number": "1669744264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "395 MAPLE STREET",
"address_2": "APT. C8",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112255226",
"telephone_number": "718-687-8221",
"fax_number": "718-773-1877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "395 MAPLE STREET",
"address_2": "APT. C8",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112255226",
"telephone_number": "718-687-8221",
"fax_number": "718-773-1877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUNO",
"first_name": "KWESI",
"middle_name": "ABDALLA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-01-30",
"last_updated": "2012-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "034211-1",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1211571",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.