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NPI 1932989654

NPI 1932989654 : BRIDGEVIEW MEDICAL PC : STATEN ISLAND, NY

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General NPI Number Information
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    NPI Number           |    1932989654
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    Entity Type          |    Organization 
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    Legal Business Name  |    BRIDGEVIEW MEDICAL PC 
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Dates
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    Enumeration Date     |    10/02/2023
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    Last Update Date     |    10/02/2023
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Provider Practice Location Address
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    Address Line         |    2955 VETERANS RD W STE 2F 
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    City                 |    STATEN ISLAND
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    State                |    NY
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    Zip                  |    10309-2504
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    Country              |    US
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    Telephone            |    929-200-3003
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2955 VETERANS RD W STE 2F 
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    City                 |    STATEN ISLAND
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    State                |    NY
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    Zip                  |    10309-2504
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    Country              |    US
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    Telephone            |    929-200-3003
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    Fax                  |    
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Authorized Official
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    Title or Position    |    MEDICAL DIRECTOR
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    Name                 |    DR. TEJAS B PATEL 
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    Credential           |    
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    Telephone            |    929-200-3003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QM1300X
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    Taxonomy Name        |    Multi-Specialty Clinic/Center
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    License Number       |    
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    License Number State |    
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