Provider Demographics
NPI:1871285718
Name:BRYDGING THE GAP
Entity type:Organization
Organization Name:BRYDGING THE GAP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:CYBULSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:610-368-9567
Mailing Address - Street 1:29 BUCKEYE RD
Mailing Address - Street 2:
Mailing Address - City:SWEDESBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-3099
Mailing Address - Country:US
Mailing Address - Phone:856-261-7067
Mailing Address - Fax:
Practice Address - Street 1:29 BUCKEYE RD
Practice Address - Street 2:
Practice Address - City:SWEDESBORO
Practice Address - State:NJ
Practice Address - Zip Code:08085-3099
Practice Address - Country:US
Practice Address - Phone:856-261-7067
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy