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General NPI Number Information
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NPI Number | 1881740637
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Entity Type | Organization
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Legal Business Name | CEDAR BRIDGE PEDIATRICS
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 249 S MAIN ST SUITE 2
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City | BARNEGAT
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State | NJ
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Zip | 08005-2301
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Country | US
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Telephone | 609-607-1010
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Fax | 609-607-9992
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Provider Business Mailing Address
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Address Line | 160 PENNSYLVANIA AVE
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City | BARNEGAT
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State | NJ
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Zip | 08005-2061
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Country | US
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Telephone | 609-607-1010
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Fax | 609-601-9992
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Authorized Official
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Title or Position | OWNER PHYSICIAN
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Name | DR. KIRA FELDMAN
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Credential | M.D.
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Telephone | 609-607-1010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MA070970
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License Number State | NJ
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