Healthcare Provider Details

I. General information

NPI: 1104383421
Provider Name (Legal Business Name): BRIDGEWAY CARE AT HOME, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2019
Last Update Date: 09/07/2022
Certification Date: 09/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 ROUTE 28
BRIDGEWATER NJ
08807-1919
US

IV. Provider business mailing address

270 ROUTE 28
BRIDGEWATER NJ
08807-1919
US

V. Phone/Fax

Practice location:
  • Phone: 908-722-7022
  • Fax: 908-725-1822
Mailing address:
  • Phone: 908-722-7022
  • Fax: 908-725-1822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: DONNY PELLIGRINO
Title or Position: DIRECTOR
Credential:
Phone: 908-722-7022