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NPI Code Detail

MEDICARE: BRUCE POMERANZ M.D.

MEDICARE: BRUCE POMERANZ M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician25MA05980300NJ
22081P2900XPain Medicine (Physical Medicine & Rehabilitation) Physician25MA05980300NJ
3204R00000XElectrodiagnostic Medicine Physician25MA05980300NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710975859
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRUCE POMERANZ M.D.
Provider Business Mailing Address
First Line : 4716 OLD GETTYSBURG RD
Second Line : LEGAL DEPARTMENT
City : MECHANICSBURG
State : PA
Zip : 17055-4325
Country : US
Telephone Number : 717-972-1139
Fax Number : 717-975-9981
Provider Business Practice Location Address
First Line : 300 MARKET ST
Second Line :
City : SADDLE BROOK
State : NJ
Zip : 07663-5309
Country : US
Telephone Number : 201-368-6047
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2005
Last Update Date : 10/17/2012

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Directions to “ BRUCE POMERANZ M.D.” Practice Location

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