BRIDGEWATER MEDICAL GROUP NPI 1821031568

NPI Information

NPI: 1821031568
Provider Name: BRIDGEWATER MEDICAL GROUP
Classification: Clinic/Center - 261QM1300X
Specialization: Multi-Specialty
Entity Type: Organization
CLIA Number: 31D0123829
Address: 766 US HIGHWAY 202/206 NORTH
SUITE 1
BRIDGEWATER, NJ
ZIP 08807
Phone: (908) 722-0808

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NPI Details

BRIDGEWATER MEDICAL GROUP is a multi-specialty clinic center in Bridgewater, NJ. BRIDGEWATER MEDICAL GROUP NPI is 1821031568. The provider is registered as an organization entity type.

The provider's business location address is:

766 US HIGHWAY 202/206 NORTH
SUITE 1
BRIDGEWATER, NJ
ZIP 08807-773
Phone: (908) 722-0808
Fax: (908) 722-3415

The provider's authorized official is Robert H Lustig .
The authorized official title is President and has the following contact phone number (908) 722-0808.

The CLIA number assigned to this NPI record is 31D0123829 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/13/2006 and was last updated on 6/20/2012.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2182	OTHER	NEW JERSEY	AETNA US HEALTHCARE GROUP
2	2790203	MEDICAID	NEW JERSEY
3	434834	MEDICARE ID-TYPE UNSPECIFIED	NEW JERSEY	MEDICARE GROUP PROVIDER #

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: 11/21/2025

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