Bridgeside Medical PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

BRIDGESIDE MEDICAL PC

Practice address

441 Wilfred Ter
Cliffside Park, NJ 07010-1401

Phone

(845) 863-3711

NPI assigned

Aug 11, 2009

Last updated

Sep 15, 2016By 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

Mr. Eugene Rezvin

Title

Owner

Phone

(845) 863-3711

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1249948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473897600000",
    "number": "1164654018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 WILFRED TER",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070101401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 WILFRED TER",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070101401",
            "telephone_number": "845-863-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGESIDE MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-11",
        "last_updated": "2016-09-15",
        "status": "A",
        "authorized_official_last_name": "REZVIN",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-863-3711",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bergen Enterprises Center LLC (North Jersey Recovery Center)
• Bergen Spine and Sports Rehabilitation Center Inc.
• Best Rehabilitation Services LLC
• Borough of Cliffside Park
• Angel Luis Bosques Jr., LMSW
• Bridgeview Physical Therapy LLC
• Heather Bryan
• Victoria Bulbin, O.D.
• Annette Buron, D.P.M.
• Danilo O Cabusas, P.T.

• Internal Medicine Physician in Cliffside Park, NJ
• Providers in Cliffside Park, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; 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.