| NPI Details | |
|---|---|
| NPI | 1043518913 |
| Enumeration Date | 03/02/2011 |
| Last Updated | 12/10/2013 |
| Entity Type | Healthcare Provider |
| Active | Over 6 years ago |
| Authorized Information | |
|---|---|
| Name | BRUCE P BRUCE |
| Position | OWNER/MEDICAL DIRECTOR |
| Phone | (973) 673-3668 |
| Fax | (862) 252-9542 |
| Practice Location | |
|---|---|
| 310 CENTRAL AVENUE SUITE 301 EAST ORANGE NJ, 07018-2835, US |
|
| Phone | (973) 673-3668 |
| Fax | (862) 252-9542 |
| Business Location | |
|---|---|
| 310 CENTRAL AVENUE SUITE 301 EAST ORANGE NJ, 07018-2835, US |
|
| Phone | (973) 673-3668 |
| Fax | (862) 252-9542 |
| Toxanomy | |
|---|---|
| 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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