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Organization

BRIDGECARE PROVIDER GROUP MA, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARIVIC VANOVER (JED) VANOVER NURSE PRACTITIONER (VICE PRESIDENT OF OPERATION)
(856) 448-3533
Entity
Organization

Contact information

Practice address
57 OLD ROAD TO 9 ACRE COR, CONCORD, MA 01742-3317
(551) 337-3278
Mailing address
57 OLD ROAD TO 9 ACRE COR, CONCORD, MA 01742-3317
(551) 337-3278

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary

Other

Enumeration date
05/27/2025
Last updated
05/27/2025
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