FAMILY HEALTH AND WELLNESS CENTER OF BRIDGEPORT LLC NPI 1669669073

NPI Information

NPI: 1669669073
Provider Name: FAMILY HEALTH AND WELLNESS CENTER OF BRIDGEPORT, LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
4699 MAIN ST
SUITE 201
BRIDGEPORT, CT
ZIP 06606
Phone: (203) 372-9002
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FAMILY HEALTH AND WELLNESS CENTER OF BRIDGEPORT, LLC is a primary care clinic center in Bridgeport, CT. FAMILY HEALTH AND WELLNESS CENTER OF BRIDGEPORT, LLC NPI is 1669669073. The provider is registered as an organization entity type.

The provider's business location address is:

4699 MAIN ST
SUITE 201
BRIDGEPORT, CT
ZIP 06606-830
Phone: (203) 372-9002
Fax: (203) 372-6747

The provider's authorized official is Jennifer Ju .
The authorized official title is Physician and has the following contact phone number (203) 372-9002.

The enumeration date for this NPI number is 9/29/2007 and was last updated on 9/29/2007.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	041401	CONNECTICUT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	H86007	MEDICARE UPIN	CONNECTICUT

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

NPI Synchronization or Removal

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