Healthcare Provider Details

I. General information

NPI: 1811331598
Provider Name (Legal Business Name): BRIDGEVIEW REHABILITATION AND MEDICAL ARTS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2013
Last Update Date: 04/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

454 MAIN STREET 3RD FLOOR
FORT LEE NJ
07024
US

IV. Provider business mailing address

PO BOX 887
FORT LEE NJ
07024
US

V. Phone/Fax

Practice location:
  • Phone: 201-969-1400
  • Fax: 201-969-1402
Mailing address:
  • Phone: 201-969-1400
  • Fax: 201-969-1402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: MANIK SINGH
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 201-969-1400