Provider Demographics
NPI:1699394239
Name:FINK DE BEAUFORT, BRUCE (PHD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:
Last Name:FINK DE BEAUFORT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:BRUCE
Other - Middle Name:
Other - Last Name:FINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:350 COBBLESTONE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:MCKEES
Mailing Address - State:PA
Mailing Address - Zip Code:15136-1000
Mailing Address - Country:US
Mailing Address - Phone:412-859-3997
Mailing Address - Fax:
Practice Address - Street 1:350 COBBLESTONE CIRCLE
Practice Address - Street 2:
Practice Address - City:MCKEES
Practice Address - State:PA
Practice Address - Zip Code:15136-1000
Practice Address - Country:US
Practice Address - Phone:412-859-3997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-14
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARP53102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARP53OtherRESEARCH PSYCHOANALYST