Kaitlin M Bourdeau, PA
Physician Assistant in Bloomfield, New Jersey
1780236489- Practice location
- 1255 Broad St Ste 201A, Bloomfield, NJ 07003-3061
- Phone
- 973-842-2100
- Fax
- —
- Last updated
- July 18, 2019
Kaitlin M Bourdeau is a Physician Assistant based in Bloomfield, NJ. Kaitlin M Bourdeau practices in Bloomfield, NJ and has the professional credentials of PA. The NPI Number for Kaitlin M Bourdeau is 1780236489 and holds a License No. 25MP00528000. The current practice location address for Kaitlin M Bourdeau is 1255 Broad St Ste 201A, Bloomfield, NJ 07003-3061 and can be reached out via phone at 973-842-2100.
Provider Profile Details
- NPI Number
- 1780236489
- Provider Name
- Kaitlin M Bourdeau
- Credential
- PA
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 1255 Broad St Ste 201A, Bloomfield, NJ 07003-3061
- Phone Number
- 973-842-2100
- Primary Taxonomy
- Physician Assistant · 363A00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- July 12, 2019
- Last Update Date
- July 18, 2019
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1255 Broad St Ste 201A
Bloomfield, NJ 07003-3061 - City
- Bloomfield
- State
- New Jersey
- Zip
- 07003-3061
- Phone Number
- 973-842-2100
Provider Business Mailing Address Details
- Address
- 135 Brakeshoe Pl
Mahwah, NJ 07430-1102 - City
- Mahwah
- State
- NJ
- Zip
- 07430-1102
- Phone Number
- 551-804-7432
License Information
- License Number
- 25MP00528000
- Taxonomy
- Physician Assistant · 363A00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Kaitlin M Bourdeau, PA?
The NPI number of Kaitlin M Bourdeau, PA is 1780236489. It was assigned on July 12, 2019 and is currently active in the NPPES registry.
What is the specialty of Kaitlin M Bourdeau, PA?
Kaitlin M Bourdeau, PA is registered under the primary taxonomy Physician Assistant (code 363A00000X), licensed under license number 25MP00528000.
Where does Kaitlin M Bourdeau, PA practice?
The practice location is 1255 Broad St Ste 201A, Bloomfield, NJ 07003-3061. The office can be reached at 973-842-2100 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1780236489 directly on the NPPES registry website.