Bruce Edward Nerenberg in Fort Wayne - Clinical

Bruce Edward Nerenberg - NPI 1063428639

Bruce Edward Nerenberg is a Clinical in Fort Wayne, Indiana. Bruce Edward Nerenberg practices all healthcare services and medical treatments related to Clinical. The NPI Number for Bruce Edward Nerenberg is 1063428639. The last update date is 2013-03-29.

Bruce Edward Nerenberg's current location address is 2121 Lake Ave, Fort Wayne, Indiana. You can contact this provider via phone number 8003608387 and fax number 2604601481. The mailing address for Bruce Edward Nerenberg is 2121 Lake Ave, Fort Wayne, Indiana. To know further, please read the information below!

Provider Profile Detail

Provider Name Bruce Edward Nerenberg
Address 2121 Lake Ave, Fort Wayne, Indiana
Phone Number 8003608387
Fax Number 2604601481
Sole Proprietor N
Credentials PH.D.

NPI Number Detail

NPI Number 1063428639
Provider Enumeration Date 2006-08-01
Last Updated Date 2013-03-29

Provider Mailing Address Detail

Address 2121 Lake Ave
City Fort Wayne
State Indiana (IN)
Post Code 468055100
Phone Number 8003608387
Fax Number 2604601481

Provider's Primary Taxonomy Detail

Speciality Clinical
Taxonomy 103Tc0700X
Licence No 057-1860
Definition:
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in

Provider's Other Legacy Identifiers

Identifier Identifier Type Identifier State Identifier Issuer
39112100 WI --

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FAQs about Bruce Edward Nerenberg

What is the unique 10-digit identification code issued to Bruce Edward Nerenberg by the Centers for Medicare & Medicaid Services?

The Bruce Edward Nerenberg has been assigned the NPI (National Provider Identifier) 1063428639 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.

Could you please share the complete physical location address where Bruce Edward Nerenberg's facilities are situated?

The facilities of Bruce Edward Nerenberg are physically located at the following address: 2121 Lake Ave, Fort Wayne, IN, 468055100.

What is Bruce Edward Nerenberg's specialized field of practice, and what is the corresponding taxonomy classification code?

The Bruce Edward Nerenberg's area of specialization is Clinical, and the corresponding taxonomy code that categorizes this field of practice is 103Tc0700X.

When did the Bruce Edward Nerenberg receive its 1063428639?

The Bruce Edward Nerenberg was issued its 1063428639 on 2006-08-01, which is the date when the organization was assigned this unique identifier.

As of what date were the details related to Bruce Edward Nerenberg most recently updated or revised?

The information pertaining to Bruce Edward Nerenberg, including its address, specialty, and other relevant details, was last updated or revised on 2013-03-29.

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