Provider Demographics
NPI:1467488213
Name:VENBRUX, NUCHANART (MD)
Entity Type:Individual
Prefix:
First Name:NUCHANART
Middle Name:
Last Name:VENBRUX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NUCHANART
Other - Middle Name:
Other - Last Name:UNHANAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3940 LOCUST LANE
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17101
Mailing Address - Country:US
Mailing Address - Phone:717-545-5787
Mailing Address - Fax:
Practice Address - Street 1:1801 NORTH FRONT STREET
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109
Practice Address - Country:US
Practice Address - Phone:717-238-8852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044973L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4468003OtherAETNA
VE103217OtherHIGHMARK BLUE SHIELD
PA0014263326Medicaid
VE103217OtherHIGHMARK BLUE SHIELD
PAF64293Medicare UPIN
F64293Medicare UPIN