Provider Demographics
NPI:1992425813
Name:OPPENHEIMER, BRUNO ROBERTO
Entity type:Individual
Prefix:DR
First Name:BRUNO
Middle Name:ROBERTO
Last Name:OPPENHEIMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13661 41ST AVE # 324
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-2464
Mailing Address - Country:US
Mailing Address - Phone:929-362-8045
Mailing Address - Fax:
Practice Address - Street 1:13661 41ST AVE # 324
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-2464
Practice Address - Country:US
Practice Address - Phone:929-362-8045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-31
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2472B0301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2472B0301XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherBiomedical EngineeringGroup - Single Specialty