1497019533 NPI number — NEWBRIDGE SERVICES, INC.

Table of content: (NPI 1497019533)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497019533 NPI number — NEWBRIDGE SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEWBRIDGE SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497019533
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/15/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
620 NWARK POMPTON TPK, SUITE 1
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POMPTON PLAINS
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07444
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-839-2520
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1069 RINGWOOD AVE
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
WANAQUE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07420
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-628-8530
Provider Business Practice Location Address Fax Number:
973-628-6856
Provider Enumeration Date:
07/03/2012

Additional Information

Authorized Official

Authorized Official Last Name:
BORDEN
Authorized Official First Name:
MICHELLE
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
973-839-2520

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  30304-22-05 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7679602 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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