Provider Demographics
NPI:1184678484
Name:BAMBERGER, STEVE (PT)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:BAMBERGER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5635
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89513-5635
Mailing Address - Country:US
Mailing Address - Phone:775-784-4041
Mailing Address - Fax:775-784-6425
Practice Address - Street 1:1664 N VIRGINIA ST
Practice Address - Street 2:MS 274 LOMBARDI BUILDING
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89557-0001
Practice Address - Country:US
Practice Address - Phone:775-784-4041
Practice Address - Fax:775-784-6425
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0241225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RPT241Medicare ID - Type Unspecified