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NPI 1891430153

NPI 1891430153 : BRIAN REID : BRIDGEWATER, NJ

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General NPI Number Information
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    NPI Number           |    1891430153
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    Entity Type          |    Individual 
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    Provider Name        |    BRIAN REID
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/02/2022
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    Last Update Date     |    11/18/2024
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Provider Practice Location Address
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    Address Line         |    630 COMMONS WAY 
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    City                 |    BRIDGEWATER
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    State                |    NJ
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    Zip                  |    08807-2806
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    Country              |    US
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    Telephone            |    908-603-8697
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    Fax                  |    908-504-3656
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Provider Business Mailing Address
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    Address Line         |    1 DIAMOND HILL RD 
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    City                 |    BERKELEY HEIGHTS
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    State                |    NJ
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    Zip                  |    07922-2104
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    Country              |    US
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    Telephone            |    908-273-4300
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    Fax                  |    
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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        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    40QA02063300
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    License Number State |    NJ
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