Active NPI
Janice Bruckner, PHD, PT
- Physical Therapist
- Philadelphia, PA
National Provider Identifier
1487890281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-012407-L
- Practice address
- 734 Lombard St
Philadelphia, PA 19147-1315 - Phone
- (215) 923-3036
- NPI assigned
- Dec 29, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-012407-L | PA | Primary |
Addresses
Primary practice location
734 Lombard St
Philadelphia, PA 19147-1315
Mailing address
734 Lombard St
Philadelphia, PA 19147-1315
Phone (215) 923-3036
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT-012407-L | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1230508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1230508800000",
"number": "1487890281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "734 LOMBARD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191471315",
"telephone_number": "215-923-3036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "734 LOMBARD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191471315",
"telephone_number": "215-923-3036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUCKNER",
"first_name": "JANICE",
"name_prefix": "Dr.",
"credential": "PHD, PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-12-29",
"last_updated": "2008-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT-012407-L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.