Basic Information
| Provider Information | |||||||||
| NPI: | 1457330706 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRUNOZZI | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | G | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 41 UNIVERSITY DR | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | NEWTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 189401873 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157107037 | ||||||||
| FaxNumber: | 2157105181 | ||||||||
| Practice Location | |||||||||
| Address1: | 1609 WOODBOURNE RD STE 101 | ||||||||
| Address2: | |||||||||
| City: | LEVITTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159451500 | ||||||||
| FaxNumber: | 2159459192 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/14/2006 | ||||||||
| LastUpdateDate: | 05/18/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | OS008501L | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0572036000 | 01 | PA | KEYSTONE EAST | OTHER | 96500 | 01 | PA | OPERATOR'S 825 WELFARE | OTHER | 08012767 | 01 | PA | MEDICARE TRAVELERS | OTHER | P9355940 | 01 | PA | OXFORD | OTHER | 5377164001 | 01 | PA | CIGNA INSURNACE CO. | OTHER | 729738 | 01 | PA | BLUE CROSS BLUE SHIELD | OTHER | 10923820 | 01 | CAQH NUMBER | OTHER | 118864300 | 01 | PA | U.S. DEPT. OF LABOR | OTHER | 16768 | 01 | PA | UMWA | OTHER | 167688828 | 01 | PA | TRICARE | OTHER | 2Y2473 | 01 | PA | HEALTHNET | OTHER | 5998012 | 01 | PA | G.H.I INSURANCE COMPANY | OTHER | 5027469 | 01 | PA | AETNA PPO | OTHER | 0073048400002 | 05 | PA | MEDICAID |