Provider Demographics
NPI:1619695814
Name:EASTBRIDGE HOME CARE
Entity Type:Organization
Organization Name:EASTBRIDGE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PAYROLL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NATALIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SYDORHUK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-385-7996
Mailing Address - Street 1:1 BRIDGE PLZ N STE 675
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-7112
Mailing Address - Country:US
Mailing Address - Phone:201-620-9994
Mailing Address - Fax:
Practice Address - Street 1:2455 LEMOINE AVE FL 2
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-6209
Practice Address - Country:US
Practice Address - Phone:201-620-9994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health