NP Primary Care Practice, PLLC
Clinic/Center, Primary Care in Bridgeport, CT. Organization (NPI-2).
NPI number1205409463
StatusActive
Last updated in NPPESJul 23, 2021
Details
- NPI
- 1205409463
- Entity type
- Organization (NPI-2)
- Legal business name
- NP Primary Care Practice, PLLC
- Organization subpart
- No
- Enumeration date
- Jul 23, 2021
- Certification date
- Jul 23, 2021
- Last updated
- Jul 23, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | – | – | Yes |
Practice location
2091 Fairfield AvenueSuite #1
Bridgeport, CT 06605-2246
Phone 203-572-7491
Mailing address
2091 Fairfield AvenueSuite #1
Bridgeport, CT 06605-2246
Phone 203-572-7491
Authorized official
Nicole J. Phillips
Medical Director/Owner
2035727491
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