Provider Demographics
NPI:1033594338
Name:BRIDGE PEDIATRICS LLC
Entity Type:Organization
Organization Name:BRIDGE PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEETA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-716-5427
Mailing Address - Street 1:2175 LEMOINE AVE
Mailing Address - Street 2:SUITE 502
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-6008
Mailing Address - Country:US
Mailing Address - Phone:917-716-5427
Mailing Address - Fax:
Practice Address - Street 1:2175 LEMOINE AVE
Practice Address - Street 2:SUITE 502
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-6008
Practice Address - Country:US
Practice Address - Phone:917-716-5427
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-28
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty