Provider Demographics
NPI:1881737641
Name:BRIDENBAUGH, JOHN ERIC (ATC)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ERIC
Last Name:BRIDENBAUGH
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:35 LONDONDERRY DR
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-1821
Mailing Address - Country:US
Mailing Address - Phone:908-788-8514
Mailing Address - Fax:732-445-6746
Practice Address - Street 1:83 ROCKAFELLER RD
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-8053
Practice Address - Country:US
Practice Address - Phone:732-445-7896
Practice Address - Fax:732-445-6746
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MT000449002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer