Healthcare Provider Details

I. General information

NPI: 1104753524
Provider Name (Legal Business Name): BRIDGET MULDOON
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 KINGS HWY N
CHERRY HILL NJ
08034-1910
US

IV. Provider business mailing address

9 HARVARD AVE
STRATFORD NJ
08084-1207
US

V. Phone/Fax

Practice location:
  • Phone: 856-486-5853
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06641500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: