Healthcare Provider Details

I. General information

NPI: 1093742082
Provider Name (Legal Business Name): BRUCE CAPLAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

564 M.O.B. EAST 100 E. LANCASTER AVE.
WYNNEWOOD PA
19096-3436
US

IV. Provider business mailing address

564 M.O.B. EAST 100 E. LANCASTER AVE.
WYNNEWOOD PA
19096-3436
US

V. Phone/Fax

Practice location:
  • Phone: 610-642-2353
  • Fax: 610-642-3278
Mailing address:
  • Phone: 610-642-2353
  • Fax: 610-642-3278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPS004569L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: