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NPI Code Detail

MEDICARE: TIFFANY NICHOLE BRIDGES DO

MEDICARE: TIFFANY NICHOLE BRIDGES DO
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1265014096
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY NICHOLE BRIDGES DO
Provider Business Mailing Address
First Line : 18 E LAUREL RD
Second Line :
City : STRATFORD
State : NJ
Zip : 08084-1327
Country : US
Telephone Number : 856-346-6000
Fax Number :
Provider Business Practice Location Address
First Line : 18 E LAUREL RD
Second Line :
City : STRATFORD
State : NJ
Zip : 08084-1327
Country : US
Telephone Number : 856-346-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2021
Last Update Date : 04/21/2021

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Directions to “ TIFFANY NICHOLE BRIDGES DO” Practice Location

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