Basic Information
| Provider Information | |||||||||
| NPI: | 1861424988 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BITTKER | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | BITTKER | ||||||||
| OtherFirstName: | THOMAS | ||||||||
| OtherMiddleName: | ELIOT | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD, LTD | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 6151 LAKESIDE DRIVE | ||||||||
| Address2: | 2001 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895118545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753294284 | ||||||||
| FaxNumber: | 7753292550 | ||||||||
| Practice Location | |||||||||
| Address1: | 6151 LAKESIDE DRIVE | ||||||||
| Address2: | 2001 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895118545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753294284 | ||||||||
| FaxNumber: | 7753292550 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2006 | ||||||||
| LastUpdateDate: | 09/19/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | MD0149 | NV | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.