Organization
BRIDGETON MEDICAL ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA J ROCCO (BILLING REPRESENTATIVE)
(856) 455-6214
Entity
Organization
Contact information
Practice address
105 MANHEIM AVE, SUITE 1, BRIDGETON, NJ 08302-2139
(856) 455-2700
(856) 455-7051
Mailing address
105 MANHEIM AVE, SUITE 1, BRIDGETON, NJ 08302
(856) 455-2700
(856) 455-7051
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8239207
—
NJ
Enumeration date
06/10/2006
Last updated
03/26/2015
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