Provider Demographics
NPI:1740303023
Name:BRIGANTI, ROBERT L JR (DPM)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:BRIGANTI
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07071-3215
Mailing Address - Country:US
Mailing Address - Phone:201-939-5877
Mailing Address - Fax:201-939-5115
Practice Address - Street 1:737 RIDGE RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:NJ
Practice Address - Zip Code:07071-3215
Practice Address - Country:US
Practice Address - Phone:201-939-5877
Practice Address - Fax:201-939-5115
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD2324213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7027508Medicaid
NJ879618Medicare PIN
NJU62063Medicare UPIN
NJ1206380001Medicare NSC