Family Health And Wellness Center Of Bridgeport, LLC
Clinic/Center, Primary Care in Bridgeport, CT. Organization (NPI-2).
NPI number1669669073
StatusActive
Last updated in NPPESSep 29, 2007
Details
- NPI
- 1669669073
- Entity type
- Organization (NPI-2)
- Legal business name
- Family Health And Wellness Center Of Bridgeport, LLC
- Organization subpart
- No
- Enumeration date
- Sep 29, 2007
- Last updated
- Sep 29, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | 041401 | CT | Yes |
Practice location
4699 Main StSuite 201
Bridgeport, CT 06606-1830
Phone 203-372-9002 · Fax 203-372-6747
Mailing address
4699 Main StSuite 201
Bridgeport, CT 06606-1830
Phone 203-372-9002 · Fax 203-372-6747
Authorized official
Jennifer Ju
Physician
2033729002
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