FAIRFIELD COUNTY INTERNAL MEDICINE AND GASTROENTEROLOGY ASSOCIATES PC (NPI# 1003849423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003849423 |
| Entity Type | Organization |
| Organization Name | FAIRFIELD COUNTY INTERNAL MEDICINE AND GASTROENTEROLOGY ASSOCIATES PC |
| Practice Address |
4641 Main St Ste 1 Bridgeport CT 06606-1827 |
| Practice Telephone | 2033744966 |
| Practice Fax Number | 2033717024 |
| Mailing Telephone | 2033744966 |
| Mailing Fax Number | 2033656637 |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2018-03-27 |
| Authorized Official Name | DR. ALAN M NELSON (PRESIDENT) |
| Authorized Official Telephone | 2033744966 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 015081 | CT | Other Service Providers |
| N | 174400000X | Specialist | 043139 | CT | Other Service Providers |
| N | 174400000X | Specialist | 019537 | CT | Other Service Providers |
| Y | 174400000X | Specialist | 014919 | CT | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 001431395 | 05 | |
| CT | 001149194 | 05 | |
| CT | 001150812 | 05 | |
| CT | 001195379 | 05 |
| Street Address |
4641 MAIN ST STE 1 |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06606-1827 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720006117 | Alan M Nelson | Specialist | 4641 Main St Ste 1, Bridgeport, CT 06606-1827 | 2006-07-17 |
| 1750314712 | Richard J Link | Specialist | 4641 Main St Ste 1, Bridgeport, CT 06606-1827 | 2006-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962023408 | Madeline Acquilano | Pharmacist | 2800 East Main St, Bridgeport, CT 06606 | 2020-05-06 |
| 1578192001 | Karin Alexandra Skalina | Student in an Organized Health Care Education/Training Program | 2800 Main St., Dept. of Medicine, Bridgeport, CT 06606 | 2020-04-06 |
| 1720641293 | Valeriia Klymenko | Student in an Organized Health Care Education/Training Program | 2800 Main Street, Department of Medicine, Bridgeport, CT 06606 | 2019-04-19 |
| 1821579996 | Ashley Liese | Nurse Practitioner | Cardiology Physicians of Fairfield County, 2679 Main St, Bridgeport, CT 06606 | 2018-08-27 |
| 1699261289 | Gema Estefania Giler-sacoto | Student in an Organized Health Care Education/Training Program | St. Vincent's Medical Center, 2800 Main Street, Department of Medicine, Bridgeport, CT 06606 | 2018-07-06 |
| 1114418365 | Jona Bumci | Physician Assistant | 3180 Main St Ste 304, Bridgeport, CT 06606 | 2018-05-23 |
| 1023471299 | Qmg4, LLC | Family Medicine | 4200 Main Street, Bridgeport, CT 06606 | 2016-04-04 |
| 1861867442 | Marie Dorothea Lisieski | Social Worker | 2400 Main Street, Bridgeport, CT 06606 | 2015-12-08 |
| 1548603384 | Gerald E. Hedley | Internal Medicine | 390 Charles Street Unit #101, Bridgeport, CT 06606 | 2013-04-11 |
| 1487997581 | Gerald Micalizzi, M.d., LLC | Radiology | 558 Fairview Avenue, Bridgeport, CT 06606 | 2013-03-27 |
| Find all providers in zip 06606 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386193993 | Tjuana Stewart | Specialist | 332 Wells St Apt 108, Bridgeport, CT 06606-5466 | 2016-09-23 |
| 1255888376 | Doreen Torres | Specialist | 243 Court D Bldg 42, Bridgeport, CT 06610 | 2016-09-07 |
| 1497164479 | Jessica Riley | Specialist | 1913 Meadowbrook Rd, Bridgeport, WV 26330-7076 | 2014-08-04 |
| 1225379449 | Rafael Mediavilla | Specialist | 33 Renwick Dr, Bridgeport, CT 06604-2037 | 2013-03-13 |
| 1306193651 | Terrence Gerard Robinson-brown | Specialist | 549 Ogden St, Bridgeport, CT 06608-1732 | 2012-08-06 |
| 1508186883 | Gold Coast Allure, LLC | Specialist | 695 Beechwood Ave, Bridgeport, CT 06605-1606 | 2010-06-09 |
| 1447497144 | Amanda Dawn Mccray | Specialist | 529 East Main St, Bridgeport, WV 26330 | 2009-01-16 |
| 1326205550 | Brent Perdrizet | Specialist | 267 Mill Hill, Bridgeport, CT 06606 | 2008-05-16 |
| 1487869228 | Leopold Strubbe | Specialist | 135 Harmony St, Bridgeport, CT 06606-4357 | 2007-05-14 |
| 1184796906 | Kathy M Hoare | Specialist | 18 Wexford Way, Bridgeport, WV 26330 | 2006-11-15 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 06606 |
Please comment or provide details below to improve the information on FAIRFIELD COUNTY INTERNAL MEDICINE AND GASTROENTEROLOGY ASSOCIATES PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.