BRIDGEPORT FAMILY MEDICINE LLC (NPI# 1548642283) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548642283 |
| Entity Type | Organization |
| Organization Name | BRIDGEPORT FAMILY MEDICINE LLC |
| Practice Address |
754 Clinton Ave Bridgeport CT 06604 |
| Mailing Address |
112 Sunnyridge Ave Fairfield CT 06824-4620 |
| Practice Telephone | 2032436018 |
| Mailing Telephone | 2032436018 |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2015-06-18 |
| Authorized Official Name | AWAIS MALIK (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 2032436018 |
| Authorized Official Credential | M.D.,CEO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
049851 | CT | Ambulatory Health Care Facilities |
| Y | 207Q00000X | Family Medicine | 049851 | CT | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205236445 | Bridgeport Family Medicine LLC | Family Medicine | 16083 Sw Upper Boones Ferry Rd, Ste 320, Tigard, OR 97224-7736 | 2014-08-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | Bridgeport Family Medicine LLC | 112 Sunnyridge Avenue, Fairfield, CT 06824 |
| Street Address |
754 CLINTON AVE |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508025594 | Awais Malik | Family Medicine | 754 Clinton Ave, Bridgeport, CT 06604-2301 | 2008-06-04 |
| 1942844949 | Shandel Reith | Registered Nurse | 754 Clinton Ave, Bridgeport, CT 06604-2301 | 2019-11-01 |
| 1407311988 | Thamara Sterling | Nurse Practitioner | 754 Clinton Ave, Bridgeport, CT 06604-2301 | 2019-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780163246 | Jill K Bebey | Pharmacist | 564 A Park Ave, Bridgeport, CT 06604 | 2018-08-07 |
| 1538663430 | Ryan Attar | Naturopath | 129 Columbia St, Bridgeport, CT 06604 | 2018-03-23 |
| 1487153375 | Fe Y Esperanza Home Care Services | Home Health | 2032 Main Street, Bridgeport, CT 06604 | 2018-02-06 |
| 1013423466 | Va.lu Able Home Care LLC | Registered Nurse | 1000 Lafayette Boulvard, Bridgeport, CT 06604 | 2017-12-21 |
| 1679970172 | Aarti Jawa | Dentist | 594 Pequonnoack Street, Bridgeport, CT 06604 | 2014-11-26 |
| 1932521473 | Anthony Santostefano | Dentist | 594 Pequonnock Street, Bridgeport, CT 06604 | 2014-01-18 |
| 1699011536 | Vanessa Frances Doyle | Naturopath | 115 Broad Street, C/o Center of Excellence, Bridgeport, CT 06604 | 2012-12-21 |
| 1942463302 | Joanna Conte Mcgary | Naturopath | 60 Lafayette Street, Naturopathic Medical Center University of Bridgeport, Bridgeport, CT 06604 | 2008-07-07 |
| 1346415221 | Jenna Lyn Blasi | Naturopath | 60 Lafayette, University of Bridgeport College of Naturopathic Medici, Bridgeport, CT 06604 | 2008-04-23 |
| 1275704462 | Watermark 3030 Park LLC | Skilled Nursing Facility | 3030 Park Ave, Bridgeport, CT 06604 | 2008-03-17 |
| Find all providers in zip 06604 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780158287 | Rejuvenation Medspa | Family Medicine | 1400 Johnson Ave Ste 4a, Bridgeport, WV 26330-1063 | 2019-01-17 |
| 1497244321 | Sanitas of Connecticut LLC | Family Medicine | 4551 Main St, Bridgeport, CT 06606-1818 | 2018-05-07 |
| 1023471299 | Qmg4, LLC | Family Medicine | 4200 Main Street, Bridgeport, CT 06606 | 2016-04-04 |
| 1013395755 | Clinisanitas, PC | Family Medicine | 4543 Main St, Bridgeport, CT 06606-1818 | 2015-05-14 |
| 1982941431 | Razia Sultana Hashmi | Family Medicine | 115 Highland Ave, Bridgeport, CT 06604-3549 | 2013-01-03 |
| 1508025594 | Awais Malik | Family Medicine | 754 Clinton Ave, Bridgeport, CT 06604-2301 | 2008-06-04 |
| 1508062423 | Bridgeport Family Practice Obgyn Clinic | Family Medicine | 615 Kendall Ave, Bridgeport, AL 35740 | 2007-06-26 |
| 1760505887 | Vinai Montricul | Family Medicine | 47910 Al Highway 277, Bridgeport, AL 35740-7206 | 2007-04-06 |
| 1942341060 | Zijad Sabovic | Family Medicine | 3000 Park Ave, Bridgeport, CT 06604-1105 | 2007-02-09 |
| 1538207295 | Bridgeport Family Health LLC | Family Medicine | 1381 Reservoir Avenue, Bridgeport, CT 06606-2502 | 2007-02-02 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 06604 |
Please comment or provide details below to improve the information on BRIDGEPORT FAMILY MEDICINE LLC.
| 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.