Provider Demographics
NPI:1770146144
Name:NEAL BRUGMAN PSYD LLC
Entity type:Organization
Organization Name:NEAL BRUGMAN PSYD LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRUGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:720-295-7605
Mailing Address - Street 1:2100 S CORONA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-4516
Mailing Address - Country:US
Mailing Address - Phone:720-295-7605
Mailing Address - Fax:720-230-5469
Practice Address - Street 1:2100 S CORONA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-4516
Practice Address - Country:US
Practice Address - Phone:720-295-7605
Practice Address - Fax:720-230-5469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-20
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty