# BRIDGESIDE MEDICAL PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164654018
- **Authorized official:** MR. EUGENE REZVIN (OWNER)
- **Authorized official phone:** (845) 863-3711

## Contact information

- **Practice address:** 441 WILFRED TER, CLIFFSIDE PARK, NJ 07010-1401
- **Practice address phone:** (845) 863-3711
- **Mailing address:** 441 WILFRED TER, CLIFFSIDE PARK, NJ 07010-1401

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/11/2009
- **Last updated:** 09/15/2016