Provider Demographics
NPI:1790718245
Name:BRUCKER, ALLISON J (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:J
Last Name:BRUCKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:51 N. 39TH STREET
Mailing Address - Street 2:SCHEIE EYE INSTITUTE
Mailing Address - City:PHIALDELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-662-8100
Mailing Address - Fax:
Practice Address - Street 1:51 N/ 39TH STREET
Practice Address - Street 2:SCHEIE EYE INSTITUTE
Practice Address - City:PHIALDELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-662-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233958207W00000X
PAMD436479207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology