MEDICARE: MS. BRIDGET A MCBRIDE NP

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
1	363LG0600X	Gerontology Nurse Practitioner	340811	NY

General Provider Information

NPI Number	:	1326033903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BRIDGET A MCBRIDE NP

Provider Business Mailing Address
First Line	:	119 PRESIDENT ST
Second Line	:	#5
City	:	BROOKLYN
State	:	NY
Zip	:	11231-2876
Country	:	US
Telephone Number	:	646-406-2828
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 PENN PLZ
Second Line	:	8TH FLOOR, OPTUM
City	:	NEW YORK
State	:	NY
Zip	:	10119-0002
Country	:	US
Telephone Number	:	646-957-5472
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	07/31/2015

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