Healthcare Provider Details

I. General information

NPI: 1801997432
Provider Name (Legal Business Name): BARTHOLOMEW DOMINICK BRIGIDI JR. PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 05/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6409 FAYETTEVILLE RD SUITE 120-118
DURHAM NC
27713-6297
US

IV. Provider business mailing address

6409 FAYETTEVILLE RD SUITE 120-118
DURHAM NC
27713-6297
US

V. Phone/Fax

Practice location:
  • Phone: 919-246-9502
  • Fax:
Mailing address:
  • Phone: 919-246-9502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number3266
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: