Provider Demographics
NPI:1801805197
Name:BRIDGES, YVETTE ANITA (MD)
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:ANITA
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 OLD SHORT HILLS RD
Mailing Address - Street 2:SUITE 505
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052
Mailing Address - Country:US
Mailing Address - Phone:973-731-9334
Mailing Address - Fax:973-731-9386
Practice Address - Street 1:101 OLD SHORT HILLS RD
Practice Address - Street 2:SUITE 505
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052
Practice Address - Country:US
Practice Address - Phone:973-731-9334
Practice Address - Fax:973-731-9386
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA45236207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
000454841OtherHIGHMARK BLUE SHIELD ID
0105098000OtherHMO ID
BR454841Medicare ID - Type Unspecified
C55653Medicare UPIN