Healthcare Provider Details

I. General information

NPI: 1598963050
Provider Name (Legal Business Name): BRIDGET S GARMISA CRNP, RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2007
Last Update Date: 12/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7056 GERMANTOWN AVE
PHILADELPHIA PA
19119-1826
US

IV. Provider business mailing address

7056 GERMANTOWN AVE
PHILADELPHIA PA
19119-1826
US

V. Phone/Fax

Practice location:
  • Phone: 215-247-2996
  • Fax:
Mailing address:
  • Phone: 215-247-2996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number953267
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number
License Number StateDC
# 4
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberSP011696
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: