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757 Route 202/206, Bridgewater, NJ 08807-1763 | |
(908) 450-7002 | |
(732) 832-2601 |
Full Name | |
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Type | Facility |
Speciality | Family Medicine |
Location | 757 Route 202/206, Bridgewater, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1699978197 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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171100000X | Acupuncturist | P-0227 (New Jersey) | Secondary |
207Q00000X | Family Medicine | 25MA07932600 (New Jersey) | Primary |
Provider Name | David Boguslavsky |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1114080231 PECOS PAC ID: 5193810471 Enrollment ID: I20071002000103 |
Mailing Address | Practice Location Address |
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757 Route 202/206, Bridgewater, NJ 08807-1763 Ph: (908) 450-7002 | 757 Route 202/206, Bridgewater, NJ 08807-1763 Ph: (908) 450-7002 |