1962241299 NPI number — MISS RENEE BRUCE MD

Table of content: MISS RENEE BRUCE MD (NPI 1962241299)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962241299 NPI number — MISS RENEE BRUCE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BRUCE
Provider First Name:
RENEE
Provider Middle Name:
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1962241299
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/22/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
DUPONT HOSPITAL FOR CHILDREN
Provider Second Line Business Mailing Address:
1600 ROCKLAND ROAD, SUITE 3D16
Provider Business Mailing Address City Name:
WILMINGTON
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19803-3607
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-651-5874
Provider Business Mailing Address Fax Number:
302-651-5954

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
DUPONT HOSPITAL FOR CHILDREN
Provider Second Line Business Practice Location Address:
1600 ROCKLAND ROAD
Provider Business Practice Location Address City Name:
WILMINGTON
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19803-3607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-651-5874
Provider Business Practice Location Address Fax Number:
302-651-5954
Provider Enumeration Date:
05/24/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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