Hertzenberg, Bruce Edward

Hertzenberg, Bruce Edward is an individual health care provider with primary practice located at 5130 Holly Ln N #3, Plymouth MN 55446-1772. He recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Surgical Technologist, which is considered as his primary health care specialty. Hertzenberg, Bruce Edward can be contacted via phone (763) 694-9248.

Contact Information

Primary practice address
5130 Holly Ln N #3 Plymouth MN 55446-1772
Phone: (763) 694-9248
Fax: (763) 694-0293
Website:
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Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Surgical Technologist 246ZS0410X SA00271 Texas

Profile Details

NPI number 1588646970
LBN Legal business name Hertzenberg, Bruce Edward
Credentials LICENSED SURG ASSIST
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 19th, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588646970 NPPES
Minnesota Other 89003 CERT. FIRST ASSISTANT
Minnesota Other SA00271 CERT. FIRST ASSISTANT
Minnesota Other 066759 CERT. FIRST ASSISTANT

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