Provider Demographics
NPI:1730354804
Name:BUCZEK & EHRMANTRAUT PC
Entity type:Organization
Organization Name:BUCZEK & EHRMANTRAUT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:BUCZEK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:804-794-5928
Mailing Address - Street 1:1241 MALL DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-4879
Mailing Address - Country:US
Mailing Address - Phone:804-794-5928
Mailing Address - Fax:804-379-6385
Practice Address - Street 1:1241 MALL DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-4879
Practice Address - Country:US
Practice Address - Phone:804-794-5928
Practice Address - Fax:804-379-6385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001121103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty