Provider Demographics
NPI:1457532996
Name:BRIDGES, FIRAS (MD)
Entity Type:Individual
Prefix:
First Name:FIRAS
Middle Name:
Last Name:BRIDGES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:786 MONTAUK HWY
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-4926
Mailing Address - Country:US
Mailing Address - Phone:631-587-5800
Mailing Address - Fax:631-669-0222
Practice Address - Street 1:786 MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4926
Practice Address - Country:US
Practice Address - Phone:631-587-5800
Practice Address - Fax:631-669-0222
Is Sole Proprietor?:No
Enumeration Date:2007-11-26
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY248143208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03103500Medicaid
NY03103500Medicaid