| |
82 George St Bridgeport CT 06604-3315 | |
(203) 579-3881 | |
(203) 332-0376 |
Full Name | |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 82 George St, Bridgeport, Connecticut |
Authorized Official Name and Position | Ludwig Spinelli (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 2036963260 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
982 E Main St Bridgeport CT 06608-1913 Ph: (203) 696-3260 | 82 George St Bridgeport CT 06604-3315 Ph: (203) 579-3881 |
NPI Number | 1215207782 |
---|---|
Provider Enumeration Date | 12/30/2011 |
Last Update Date | 12/30/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215207782 | NPI | - | NPPES |
004234788 | Medicaid | CT | |
C00383 | Other | CT | MEDICARE PART B |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 0427 (Connecticut) | Primary |
Clinisanitas, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4543 Main St, Bridgeport, CT 06606 Phone: 305-921-7621 Fax: 305-921-7355 | |
Primed Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4699 Main St, Suite 105 Attn: Med3000, Bridgeport, CT 06606 Phone: 203-944-1940 Fax: 203-402-4196 | |
Wellington Provider Group Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1000 Lafayette Blvd Ste 1100, Bridgeport, CT 06604 Phone: 859-518-8817 Fax: 859-201-1084 | |
Fairfield Clinical Services Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 978 E Main St, Bridgeport, CT 06608 Phone: 203-549-1872 | |