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Contact Information

JERROLD L BRUCKER, LCSW
1101 HILLVIEW DR
ALLENTOWN, PA18103-6046
 Phone: 610-730-2744
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for JERROLD L BRUCKER · (Male)

NPI Number 1659381606
Status Active
Credentials LCSW (Licensed Clinical Social Worker)
Entity Individual
Enumeration date 08/09/2006
Last updated 04/29/2011 - About 15 years ago
Sole proprietor 1 Yes
Identifiers
  • PA License # CW014557
  • PA Medicaid 0070975930002
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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