Bridgeton SNF LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

BRIDGETON SNF LLC

Practice address

99 Manheim Ave
Bridgeton, NJ 08302-2114

Phone

(856) 455-2100

NPI assigned

Mar 17, 2025

Last updated

Mar 17, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shlomo Fogel

Title

Managing Member

Phone

(347) 576-3754

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1742169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742169600000",
    "number": "1104626332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 TRUMAN AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015662",
            "telephone_number": "347-576-3754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 MANHEIM AVE",
            "city": "BRIDGETON",
            "state": "NJ",
            "postal_code": "083022114",
            "telephone_number": "856-455-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGETON SNF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-17",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A",
        "authorized_official_last_name": "FOGEL",
        "authorized_official_first_name": "SHLOMO",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "347-576-3754"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.