Provider Demographics
NPI:1487823134
Name:EIMER, BRUCE N (PHD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:N
Last Name:EIMER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7546 PEBBLE SHORES TER
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-6910
Mailing Address - Country:US
Mailing Address - Phone:561-377-1039
Mailing Address - Fax:215-893-3081
Practice Address - Street 1:7546 PEBBLE SHORES TER
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-6910
Practice Address - Country:US
Practice Address - Phone:561-377-1039
Practice Address - Fax:215-893-3081
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004665L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAEI481285Medicare PIN