Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 25MD00112800 | NJ |
Y | 222Z00000X | Podiatrist | 25MD00112800 | NJ |
N | 213ES0131X | Foot Surgery | 25MD00112800 | NJ |
NPI | 1225035033 |
---|---|
Provider Name | Dr. Bruce David Bitcover |
First Address | Lawrenceville, NJ 08648-2909 |
Second Address | Lawrenceville, NJ 08648-2909 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 08/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2385805 | (05) | NJ |
F09918 | HEALTH NET (01) | NJ |
T44528 | (02) |