Organization
BRIDGECARE PROVIDER GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IYAD BAKER (OWNER)
(201) 596-6262
Entity
Organization
Contact information
Practice address
493 BLACK OAK RIDGE RD, WAYNE, NJ 07470-6501
(973) 692-9500
Mailing address
173 BRIDGE PLZ N, FORT LEE, NJ 07024-7575
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/17/2022
Last updated
10/17/2022
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