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General NPI Number Information
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NPI Number | 1255387262
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Entity Type | Organization
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Legal Business Name | DR. S.B. BREGMAN, LLC
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 06/02/2010
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Provider Practice Location Address
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Address Line | 2115 MILLBURN AVE
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-3724
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Country | US
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Telephone | 973-763-5525
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Fax | 973-763-7541
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Provider Business Mailing Address
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Address Line | 2115 MILLBURN AVE
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-3724
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Country | US
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Telephone | 973-763-5525
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Fax | 973-763-7541
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. SALLY BETH BREGMAN
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Credential | O.D.
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Telephone | 973-763-5525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4224
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License Number State | NJ
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