Brian Bechtold

Individual provider Active NPI Physician Assistant · Edgewater, NJ

NPI 1003882598 · NPPES record last updated Apr 15, 2008

Key facts

NPI
1003882598
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
25MP00144200 (NJ)
Practice address
103 River Rd
Edgewater, NJ 07020-1010
Phone
(201) 941-8100
Fax
(201) 941-2899
NPI assigned
Feb 24, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: brian.bechtold.2@15902.direct.athenahealth.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00144200 NJ Yes

Addresses

Primary practice location

103 River Rd
Edgewater, NJ 07020-1010

Mailing address

103 River Rd
Edgewater, NJ 07020-1010
Phone (201) 941-8100

Other providers in Edgewater, NJ

All providers in Edgewater, NJ · Physician Assistant in New Jersey

Sources for this page

Verify at the official NPI Registry.