Individual
DR. PHILLIP MOSES BRIDGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
50 LEROY STREET, POTSDAM, NY 13676
(315) 265-3300
Mailing address
1111 PATTERSON ST, OGDENSBURG, NY 13669-3840
(315) 393-9113
(315) 393-9127
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
166862-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
166862-1
LICENSE
NY
Enumeration date
12/21/2006
Last updated
09/13/2007
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