Provider Demographics
NPI:1124422431
Name:SKYBRIDGE HEALTHCARE LIMITED LIABILITY COMPANY
Entity type:Organization
Organization Name:SKYBRIDGE HEALTHCARE LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:KUGLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-704-8778
Mailing Address - Street 1:720 RTE 202/206
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-1746
Mailing Address - Country:US
Mailing Address - Phone:908-704-8778
Mailing Address - Fax:908-704-8172
Practice Address - Street 1:720 RTE 202/206
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-1746
Practice Address - Country:US
Practice Address - Phone:908-704-8778
Practice Address - Fax:908-704-8172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-15
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD002274800213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU95049Medicare UPIN