Bruce P Kist
Individual provider Active NPI Driver · Spotswood, NJ
NPI 1477009587 · NPPES record last updated Aug 29, 2016
Key facts
- NPI
- 1477009587
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- K46751007701492 (NJ)
- Practice address
- 44 Hamilton Dr
Spotswood, NJ 08884-1271 - Phone
- (732) 261-0234
- NPI assigned
- Aug 29, 2016
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| K46751007701492 | NJ | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | |||
| Driver | 172A00000X | K46751007701492 | NJ | Yes |
Addresses
Primary practice location
44 Hamilton Dr
Spotswood, NJ 08884-1271
Mailing address
44 Hamilton Dr
Spotswood, NJ 08884-1271
Phone (732) 261-0234
Other providers in Spotswood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.