# BODNER PHYSICIAN SERVICES PA

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

## Provider details

- **NPI number:** 1912416959
- **Authorized official:** BRADLEY BODNER DO (OWNER/MD)
- **Authorized official phone:** (732) 333-8155

## Contact information

- **Practice address:** 65 STATE ROUTE 34 STE 4, MORGANVILLE, NJ 07751-4262
- **Practice address phone:** (732) 333-8155
- **Mailing address:** 65 STATE ROUTE 34 STE 4, MORGANVILLE, NJ 07751-4262
- **Mailing address phone:** (732) 333-8155

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 25MB08845000 | NJ | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |

## Other

- **Enumeration date:** 09/21/2017
- **Last updated:** 09/12/2022