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NPI Code Detail

MEDICARE: BRIDGE PEDIATRICS LLC

MEDICARE: BRIDGE PEDIATRICS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician

General Provider Information

NPI Number : 1033594338
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIDGE PEDIATRICS LLC
Provider Business Mailing Address
First Line : 2175 LEMOINE AVE
Second Line : SUITE 502
City : FORT LEE
State : NJ
Zip : 07024-6008
Country : US
Telephone Number : 917-716-5427
Fax Number :
Provider Business Practice Location Address
First Line : 2175 LEMOINE AVE
Second Line : SUITE 502
City : FORT LEE
State : NJ
Zip : 07024-6008
Country : US
Telephone Number : 917-716-5427
Fax Number :
Authorized Official
Title or Position : DOCTOR
Name : DR. GEETA KUMAR
Credential : MD
Telephone Number : 917-716-5427
Provider Enumeration Date : 07/28/2015
Last Update Date : 06/27/2016

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Directions to “BRIDGE PEDIATRICS LLC ” Practice Location

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