Provider Demographics
NPI:1225035033
Name:BITCOVER, BRUCE DAVID (DPM)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:DAVID
Last Name:BITCOVER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 LAWRENCEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2909
Mailing Address - Country:US
Mailing Address - Phone:609-896-0770
Mailing Address - Fax:609-896-3008
Practice Address - Street 1:2030 LAWRENCEVILLE RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2909
Practice Address - Country:US
Practice Address - Phone:609-896-0770
Practice Address - Fax:609-896-3008
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00112800213E00000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2385805Medicaid
NJF09918OtherHEALTH NET
NJ2385805Medicaid
NJF09918OtherHEALTH NET