Provider Demographics
NPI:1629685524
Name:MBELLA, BRIDGET SALLY JOKE (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:SALLY JOKE
Last Name:MBELLA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5161 FOXTAIL PINE ST
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-7452
Mailing Address - Country:US
Mailing Address - Phone:302-416-1808
Mailing Address - Fax:
Practice Address - Street 1:5161 FOXTAIL PINE ST
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-7452
Practice Address - Country:US
Practice Address - Phone:302-416-1808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker