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BRIDGEPORT FAMILY MEDICINE LLC NPI 1548642283


NPI Information

NPI: 1548642283
Provider Name: BRIDGEPORT FAMILY MEDICINE LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 07D2197677

Address:
754 CLINTON AVE
BRIDGEPORT, CT
ZIP 06604
Phone: (203) 243-6018
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BRIDGEPORT FAMILY MEDICINE LLC is a family medicine in Bridgeport, CT. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. BRIDGEPORT FAMILY MEDICINE LLC NPI is 1548642283. The provider is registered as an organization entity type.

The provider's business location address is:

754 CLINTON AVE
BRIDGEPORT, CT
ZIP 06604
Phone: (203) 243-6018

The provider's authorized official is Awais Malik .
The authorized official title is Medical Director and has the following contact phone number (203) 243-6018.

The CLIA number assigned to this NPI record is 07D2197677 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/18/2015 and was last updated on 6/18/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QU0200XClinic/CenterUrgent Care049851CONNECTICUTNo
2207Q00000XFamily Medicine049851CONNECTICUTYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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