Organization
THE BRIDGE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN WIVIOTT J.D. (EXECUTIVE DIRECTOR)
(212) 663-3000
Entity
Organization
Contact information
Practice address
248 W 108TH ST, 6TH FLOOR, NEW YORK, NY 10025-2956
(212) 663-3000
(212) 280-1793
Mailing address
248 W 108TH ST, 6TH FLOOR, NEW YORK, NY 10025-2956
(212) 663-3000
(212) 280-1793
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00273267
—
NY
05
—
01305059
—
NY
05
—
02187240
—
NY
Enumeration date
11/09/2006
Last updated
05/28/2015
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