Provider Demographics
NPI:1962631846
Name:GERALD NORENSBERG DO PA
Entity Type:Organization
Organization Name:GERALD NORENSBERG DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:NORENSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-755-2453
Mailing Address - Street 1:8327 W ATLANTIC BLVD
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-7452
Mailing Address - Country:US
Mailing Address - Phone:954-755-2453
Mailing Address - Fax:954-755-5436
Practice Address - Street 1:8327 W ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-7452
Practice Address - Country:US
Practice Address - Phone:954-755-2453
Practice Address - Fax:954-755-5436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty