Bruce Theall DPM LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

BRUCE THEALL DPM LLC

Practice address

310 Central Avenue
Suite 301
East Orange, NJ 07018-2835

Phone

(973) 673-3668

Fax

(862) 252-9542

NPI assigned

Mar 2, 2011

Last updated

Dec 10, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bruce P Theall, MDNPI 1831187434

Title

Owner/Medical Director

Phone

(973) 673-3668

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bruce Preston Theall, DPM

  • Podiatrist
  • East Orange, NJ
  • NPI 1831187434
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1299024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386633600000",
    "number": "1043518913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 CENTRAL AVENUE",
            "address_2": "SUITE 301",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070182835",
            "telephone_number": "973-673-3668",
            "fax_number": "862-252-9542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 CENTRAL AVENUE",
            "address_2": "SUITE 301",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070182835",
            "telephone_number": "973-673-3668",
            "fax_number": "862-252-9542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE THEALL DPM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-02",
        "last_updated": "2013-12-10",
        "status": "A",
        "authorized_official_last_name": "THEALL",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "973-673-3668",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanya Mashae Brown-Sampson, LSW
• Craig A. Brown, RPA-C
• Florence Marie Brown, RN, MSN, APN,C
• Ivette Brown, ED.D
• Kristine Jennay Brown, MSW, LCSW
• William Brujan
• Sergio Bueno, D.M.D.
• Larry Burroughs
• Denise Kathleen Busby, M.ED.,RD,LDN
• David J. Byrne, OTR

• Foot & Ankle Surgery Podiatrist in East Orange, NJ
• Providers in East Orange, NJ by specialty
• Foot & Ankle Surgery Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.