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General NPI Number Information
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NPI Number | 1477616076
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Entity Type | Organization
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Legal Business Name | BRIDGEWATER INTERNAL MEDICINE
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 06/09/2010
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Provider Practice Location Address
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Address Line | 215 UNION AVE SUITE E
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City | BRIDGEWATER
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State | NJ
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Zip | 08807-3063
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Country | US
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Telephone | 908-685-1818
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Fax | 908-685-8225
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Provider Business Mailing Address
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Address Line | 215 UNION AVE SUITE E
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City | BRIDGEWATER
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State | NJ
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Zip | 08807-3063
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Country | US
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Telephone | 908-685-1818
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Fax | 908-685-8225
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHIOW JANE CHENG
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Credential | M.D.
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Telephone | 908-685-1818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MA29595
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License Number State | NJ
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