Provider Demographics
NPI:1154848927
Name:BRUMMER, BRIDGET (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:BRUMMER
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 ARIZONA DR
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-7155
Mailing Address - Country:US
Mailing Address - Phone:201-463-6051
Mailing Address - Fax:
Practice Address - Street 1:300 CORPORATE CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-8737
Practice Address - Country:US
Practice Address - Phone:732-761-0302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00772300225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist