Healthcare Provider Details

I. General information

NPI: 1225995202
Provider Name (Legal Business Name): BH NORTHBRIDGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2875 MAIN ST
BRIDGEPORT CT
06606-4204
US

IV. Provider business mailing address

2875 MAIN ST
BRIDGEPORT CT
06606-4204
US

V. Phone/Fax

Practice location:
  • Phone: 203-336-0232
  • Fax:
Mailing address:
  • Phone: 203-336-0232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: YEHUDA PEPPER
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 845-304-1140