Healthcare Provider Details

I. General information

NPI: 1255470696
Provider Name (Legal Business Name): BRUCE ALTMAN PSY'D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 03/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MARKET ST UNIT 1G
PORTSMOUTH NH
03801-3456
US

IV. Provider business mailing address

500 MARKET ST UNIT 1G
PORTSMOUTH NH
03801-3456
US

V. Phone/Fax

Practice location:
  • Phone: 603-427-1428
  • Fax: 603-431-5538
Mailing address:
  • Phone: 603-427-1428
  • Fax: 603-431-5538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number491
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: