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NPI Code Detail

MEDICARE: DR. BRUCE WAYNE HOLMES PSY.D

MEDICARE: DR. BRUCE WAYNE HOLMES PSY.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
1103TC0700XClinical Psychologist016052NY

General Provider Information

NPI Number : 1750354684
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRUCE WAYNE HOLMES PSY.D
Provider Business Mailing Address
First Line : FIRST MONTGOMERY DRIVE
Second Line : 35-B
City : MOUNT HOLLY
State : NJ
Zip : 08060
Country : US
Telephone Number : 609-562-5670
Fax Number :
Provider Business Practice Location Address
First Line : 5250 NEW JERSEY AVE
Second Line :
City : FORT DIX
State : NJ
Zip : 08640-5017
Country : US
Telephone Number : 609-562-5670
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2006
Last Update Date : 08/19/2015

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