Provider Demographics
NPI:1821183765
Name:BRIDGES BEHAVIORAL HEALTH CARE
Entity Type:Organization
Organization Name:BRIDGES BEHAVIORAL HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:PITERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-920-9050
Mailing Address - Street 1:PO BOX 1599
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-1060
Mailing Address - Country:US
Mailing Address - Phone:732-920-9050
Mailing Address - Fax:732-920-9051
Practice Address - Street 1:74 BRICK BLVD
Practice Address - Street 2:SUITE 117, BLDG. 4
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-7984
Practice Address - Country:US
Practice Address - Phone:732-920-9050
Practice Address - Fax:732-920-9051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ084574Medicare ID - Type Unspecified