Organization
BRIDGEWATER MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT H LUSTIG D.O. (PRESIDENT)
(908) 722-0808
Entity
Organization
Contact information
Practice address
766 US HIGHWAY 202/206 NORTH, SUITE 1, BRIDGEWATER, NJ 08807-1773
(908) 722-0808
(908) 722-3415
Mailing address
766 US HIGHWAY 202/206, SUITE 1, BRIDGEWATER, NJ 08807-1777
(908) 722-0808
(908) 722-3415
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2182
AETNA US HEALTHCARE GROUP
NJ
05
—
2790203
—
NJ
Enumeration date
06/13/2006
Last updated
06/20/2012
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