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General NPI Number Information
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NPI Number | 1396818076
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Entity Type | Individual
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Provider Name | JENNIFER BRIGHT DISMUKES D.O.
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Gender | Female
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 10/28/2015
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Provider Practice Location Address
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Address Line | 88 ORCHARD RD SUITE 2-6
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City | SKILLMAN
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State | NJ
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Zip | 08558-2642
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Country | US
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Telephone | 609-228-6896
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Fax | 940-293-8585
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Provider Business Mailing Address
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Address Line | 88 ORCHARD RD SUITE 2-6
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City | SKILLMAN
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State | NJ
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Zip | 08558-2642
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Country | US
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Telephone | 609-228-6896
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Fax | 940-293-8585
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | M7951
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | M7951
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MB09244600
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number | 25MB09244600
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License Number State | NJ
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Taxonomy #5
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 25MB09244600
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License Number State | NJ
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Taxonomy #6
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number | M7951
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License Number State | TX
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