NPI Details | |
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NPI | 1043518913 |
Enumeration Date | 03/02/2011 |
Last Updated | 12/10/2013 |
Entity Type | Healthcare Provider |
Active | Over 7 years ago |
Authorized Information | |
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Name | BRUCE P BRUCE |
Position | OWNER/MEDICAL DIRECTOR |
Phone | (973) 673-3668 |
Fax | (862) 252-9542 |
Practice Location | |
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310 CENTRAL AVENUE SUITE 301 EAST ORANGE NJ, 07018-2835, US |
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Phone | (973) 673-3668 |
Fax | (862) 252-9542 |
Business Location | |
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310 CENTRAL AVENUE SUITE 301 EAST ORANGE NJ, 07018-2835, US |
|
Phone | (973) 673-3668 |
Fax | (862) 252-9542 |
Toxanomy | |
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Taxonomy Code | 332B00000X |
License State | |
License Number | |
Remove 1043518913 NPI Number |
According to our database, Bruce Theall Dpm Llc NPI is 1043518913, taxonomy code is 332B00000X Bruce Theall Dpm Llc physically located at 310 Central Avenue, East Orange NJ, 07018-2835. NPI Number 1033115704 has the healthcare provider type.
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1043518913 NPI number is provided on an as is basis without warranty of any kind. 1043518913 is maintained by the National Plan & Provider Enumeration System. The contents of Bruce Theall Dpm Llc are for informational purposes only.
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