Christian Heineken, MD | |
3180 Main St, Suite 301, Bridgeport, CT 06606-4237 | |
(203) 373-9100 | |
(203) 365-8492 |
Full Name | Christian Heineken |
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Gender | Male |
Speciality | Internal Medicine - Geriatric Medicine |
Location | 3180 Main St, Bridgeport, Connecticut |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003875931 | NPI | - | NPPES |
001247865 | Medicaid | CT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0300X | Internal Medicine - Geriatric Medicine | 024786 (Connecticut) | Primary |
207R00000X | Internal Medicine | 024786 (Connecticut) | Secondary |
Entity Name | Northeast Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1043278351 PECOS PAC ID: 1254233836 Enrollment ID: O20040123000522 |
Mailing Address | Practice Location Address |
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Christian Heineken, MD 3180 Main St, Suite 301, Bridgeport, CT 06606-4237 Ph: (203) 373-9100 | Christian Heineken, MD 3180 Main St, Suite 301, Bridgeport, CT 06606-4237 Ph: (203) 373-9100 |
Mitchell Andrew Fogel, M.D. Geriatric Medicine Medicare: Medicare Enrolled Practice Location: 900 Madison Ave, Suite 209, Bridgeport, CT 06606 Phone: 203-335-0195 Fax: 203-335-7293 | |
Pasquale Masone, MD Geriatric Medicine Medicare: Medicare Enrolled Practice Location: 3180 Main St, Suite 301, Bridgeport, CT 06606 Phone: 203-373-9100 Fax: 203-365-8492 | |
Kevin B Panzer, MD Geriatric Medicine Medicare: Medicare Enrolled Practice Location: 1381 Reservoir Ave., Bridgeport, CT 06606 Phone: 203-371-5197 | |
Ms. Lucia Plichtova, M.D. Geriatric Medicine Medicare: Medicare Enrolled Practice Location: 267 Grant Street, Bridgeport, CT 06610 Phone: 203-384-3792 | |
Hilda Daureen Kyotakoze, M.D. Geriatric Medicine Medicare: Medicare Enrolled Practice Location: 4920 Main St Fl 2, Bridgeport, CT 06606 Phone: 203-371-2986 | |
Karen A Hutchinson, M.D. Geriatric Medicine Medicare: Medicare Enrolled Practice Location: 226 Mill Hill Ave, 3rd Floor, Bridgeport, CT 06610 Phone: 203-384-3873 Fax: 203-384-3829 |