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BRIDGEWATER PEDIATRICS LLC NPI 1255579975


NPI Information

NPI: 1255579975
Provider Name: BRIDGEWATER PEDIATRICS LLC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 22D1098372

Address:
1029 PLEASANT ST
SUITE 100
BRIDGEWATER, MA
ZIP 02324
Phone: (508) 697-8116
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BRIDGEWATER PEDIATRICS LLC is a pediatrics in Bridgewater, MA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. BRIDGEWATER PEDIATRICS LLC NPI is 1255579975. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1029 PLEASANT ST
SUITE 100
BRIDGEWATER, MA
ZIP 02324
Phone: (508) 697-8116
Fax: (508) 697-8117

The provider's authorized official is Fred D Kern .
The authorized official title is Managing Owner and has the following contact phone number (508) 697-8116.

The CLIA number assigned to this NPI record is 22D1098372 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 2/3/2009 and was last updated on 8/10/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics57747MASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1E01880MEDICARE UPINMASSACHUSETTS
2J06281OTHERBCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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