| The Bridge, Inc. | |
|
248 W 108th St 6th Floor New York NY 10025-2956 | |
| (212) 663-3000 | |
| (212) 280-1793 |
| Full Name | The Bridge, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 248 W 108th St, New York, New York |
| Authorized Official Name and Position | Susan Wiviott (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2126633000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Bridge, Inc. 248 W 108th St 6th Floor New York NY 10025-2956 Ph: (212) 663-3000 | The Bridge, Inc. 248 W 108th St 6th Floor New York NY 10025-2956 Ph: (212) 663-3000 |
| NPI Number | 1831269315 |
|---|---|
| Provider Enumeration Date | 11/09/2006 |
| Last Update Date | 05/28/2015 |
| Medicare PECOS PAC ID | 3476576273 |
|---|---|
| Medicare Enrollment ID | O20060106000770 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831269315 | NPI | - | NPPES |
| 00273267 | Medicaid | NY | |
| 01305059 | Medicaid | NY | |
| 02187240 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Victor A Mcgregor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063514289 PECOS PAC ID: 1951391671 Enrollment ID: I20040514000778 |
| Provider Name | Tarsha M Hunter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376718452 PECOS PAC ID: 9638114630 Enrollment ID: I20050621000480 |
| Provider Name | Lisa Ferrari |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134459464 PECOS PAC ID: 3870515497 Enrollment ID: I20051223000263 |
| Provider Name | Elizabeth A Cahn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932324662 PECOS PAC ID: 7416970215 Enrollment ID: I20060106000826 |
| Provider Name | Gloria Zicht |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104906973 PECOS PAC ID: 0749207421 Enrollment ID: I20070412000650 |
| Provider Name | Michel S. Vington |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376609925 PECOS PAC ID: 5092808899 Enrollment ID: I20070911000097 |
| Provider Name | Piali M Das |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083749477 PECOS PAC ID: 0345327383 Enrollment ID: I20080401000865 |
| Provider Name | Rhiannon K Larson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659617470 PECOS PAC ID: 0042533481 Enrollment ID: I20141216001682 |
| Provider Name | Veronica A Zephyrine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659782399 PECOS PAC ID: 5496073728 Enrollment ID: I20150416000389 |
| Provider Name | Linda J Lewin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578904538 PECOS PAC ID: 1355643339 Enrollment ID: I20160107002022 |
| Provider Name | Eliza R Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669954087 PECOS PAC ID: 3577800382 Enrollment ID: I20190131001509 |
| Provider Name | Jessica L Gatt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386007755 PECOS PAC ID: 4385980051 Enrollment ID: I20201110001206 |
| Provider Name | Laura Kathir |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750758314 PECOS PAC ID: 6204137250 Enrollment ID: I20211118002271 |
| Provider Name | Mary Elizabeth Stone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508137035 PECOS PAC ID: 7911397716 Enrollment ID: I20211210000504 |
| Provider Name | James Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467122077 PECOS PAC ID: 1254726649 Enrollment ID: I20220322001562 |
| Provider Name | Jeremy Klopman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457796799 PECOS PAC ID: 8224425459 Enrollment ID: I20220418002270 |
| Provider Name | Caroline Hope Bjorkman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285122317 PECOS PAC ID: 8921344383 Enrollment ID: I20221213000476 |
| Provider Name | Jessica O'neill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912564923 PECOS PAC ID: 8628440880 Enrollment ID: I20230216000753 |
| Provider Name | Ebony Nicole Knowlin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063864841 PECOS PAC ID: 8628422748 Enrollment ID: I20230922003472 |
| Provider Name | Sophia Faha |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679070486 PECOS PAC ID: 2668829367 Enrollment ID: I20231116001932 |
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