Healthcare Provider Details

I. General information

NPI: 1124241567
Provider Name (Legal Business Name): CEDARBRIDGE MEDICAL ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 05/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

985 CEDARBRIDGE AVE
BRICK NJ
08723-4111
US

IV. Provider business mailing address

985 CEDARBRIDGE AVE
BRICK NJ
08723-4111
US

V. Phone/Fax

Practice location:
  • Phone: 732-477-5600
  • Fax: 732-477-1899
Mailing address:
  • Phone: 732-477-5600
  • Fax: 732-477-1899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNJ

VIII. Authorized Official

Name: DR. RICHARD REISHER
Title or Position: PRESIDENT
Credential: D.O.
Phone: 732-477-5600