Provider Demographics
NPI:1902057482
Name:KINDER, BRIDGETTE JUDE SHEA (LAC)
Entity Type:Individual
Prefix:MRS
First Name:BRIDGETTE
Middle Name:JUDE SHEA
Last Name:KINDER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:BRIDGETTE
Other - Middle Name:JUDE
Other - Last Name:SHEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:2 FRANKLIN SQUARE E1
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866
Mailing Address - Country:US
Mailing Address - Phone:518-538-6568
Mailing Address - Fax:206-903-1893
Practice Address - Street 1:2 FRANKLIN SQUARE E1
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866
Practice Address - Country:US
Practice Address - Phone:518-538-6568
Practice Address - Fax:206-903-1893
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60046796171100000X
NY004195-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist