Basic Information
| Provider Information | |||||||||
| NPI: | 1598963050 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GARMISA | ||||||||
| FirstName: | BRIDGET | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | CRNP, RD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7056 GERMANTOWN AVE | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191191826 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2152472996 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7056 GERMANTOWN AVE | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191191826 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2152472996 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2007 | ||||||||
| LastUpdateDate: | 12/12/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | 953267 | RI | N | Dietary & Nutritional Service Providers | Dietitian, Registered | 133VN1004X | MD | N | Dietary & Nutritional Service Providers | Dietitian, Registered | Nutrition, Pediatric | 133VN1004X | DC | N | Dietary & Nutritional Service Providers | Dietitian, Registered | Nutrition, Pediatric | 363LP0200X | SP011696 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.