Healthcare Provider Details

I. General information

NPI: 1386509107
Provider Name (Legal Business Name): BRIDGEWAY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2025
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 COMMONS WAY
SOMERSET NJ
08873-4692
US

IV. Provider business mailing address

201 COMMONS WAY
SOMERSET NJ
08873-4692
US

V. Phone/Fax

Practice location:
  • Phone: 848-200-6278
  • Fax: 848-200-6278
Mailing address:
  • Phone: 732-498-9874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: EDWIN BOSIRE
Title or Position: CEO
Credential:
Phone: 732-498-9874