1013280825 NPI number — JAMES F. BRUNGO, D.P.M.

Table of content: (NPI 1013280825)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013280825 NPI number — JAMES F. BRUNGO, D.P.M.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JAMES F. BRUNGO, D.P.M.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013280825
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/10/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8035 MCKNIGHT RD
Provider Second Line Business Mailing Address:
ANDRE PLAZA, SUITE 104
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15237-3036
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-369-0255
Provider Business Mailing Address Fax Number:
412-369-0488

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8035 MCKNIGHT RD
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15237-3036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-369-0255
Provider Business Practice Location Address Fax Number:
412-369-0488
Provider Enumeration Date:
02/10/2012

Additional Information

Authorized Official

Authorized Official Last Name:
BRUNGO
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
412-369-0255

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100961 . This is a "MEDICARE ID - TYPE UNSPECIFIED" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1002262 . This is a "GATEWAY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 103906 . This is a "UPMC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1059129 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 77828 . This is a "US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 480019810 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100961 . This is a "HIGHMARK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 31785 . This is a "HEALTH AMERICA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 63853 . This is a "MEDPLUS" identifier . This identifiers is of the category "OTHER".




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