KELLY M BUCCI-DIDOMENICO


Address: 479 Helen St, Bridgeport, CT 06608-1321
Phone: 2035798310

KELLY M BUCCI-DIDOMENICO (NPI# 1568795094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1568795094
Entity Type Individual
Full Name KELLY M BUCCI-DIDOMENICO
Practice Address 479 Helen St
Bridgeport
CT 06608-1321
Mailing Address 471 Barnum Ave
Bridgeport
CT 06608-2409
Practice Telephone 2035798310
Practice Fax Number 2036833620
Mailing Telephone 2035763885
Mailing Fax Number 2036833620
Enumeration Date 2009-09-16
Last Update Date 2015-02-09
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
1809 CT Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
CT 004234788 05

Office Location

Street Address 479 HELEN ST
City BRIDGEPORT
State CT
Zip Code 06608-1321

Providers in the same location

NPI Name Taxonomy Address Enumeration
1558480673 City of Bridgeport Health Dept. Clinic/Center 479 Helen St, Bridgeport, CT 06608-1321 2007-03-28
1518187087 Kettelie Paulemon Social Worker 479 Helen St, Bridgeport, CT 06608-1321 2007-04-26

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1184193591 Full Circle Youth Empowerment Community/Behavioral Health 583-585 East Main Street, Bridgeport, CT 06608 2018-11-14
1225548332 Vicarah, LLC Home Health 941 East Main Street, Bridgeport, CT 06608 2017-10-03
1285092346 Heavenly Providers, LLC Home Health 1071 William St, Bridgeport, CT 06608 2016-02-04
1659590131 Annette Tirado Social Worker 982 East Main St, Bridgeport, CT 06608 2007-04-24
1629023536 Brenda I Kulikowski Midwife 982 East Main Street, Optimus Health Care, Bridgeport, CT 06608 2006-05-23
1043695588 Kirithika Mohanathaas Internal Medicine 471 Barnum Ave, Bridgeport, CT 06608 2015-07-27
1871749937 Michele J Feinberg Psychiatry & Neurology 982 E Main St, Bridgeport, CT 06608 2008-08-08
1023225646 Regional Network of Programs, Inc. Community Based Residential Treatment Facility, Mental Illness 74 Huntington Rd, Bridgeport, CT 06608-1006 2007-05-16
1295013910 Lorraine Dionne Brooks-williams Registered Nurse 100 Putnam St, Ph, Bridgeport, CT 06608-1045 2011-07-29
1689157471 Tageldin Banaga Driver 1333 E Main St Apt 5, Bridgeport, CT 06608-1400 2018-09-08
Find all providers in zip 06608

Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1861915019 Stephanie Jean Fluharty Nurse Practitioner 1511 Johnson Ave Ste 104, Bridgeport, WV 26330-1016 2017-07-19
1730601006 Katherine Smith Carter Nurse Practitioner 68 Woodland Ave, Bridgeport, CT 06605-3457 2017-07-08
1285186148 Helen Leahy Nurse Practitioner 439 Mill Hill Ave., Bridgeport, CT 06610 2016-10-26
1588119408 Lisa M Finoia Nurse Practitioner 2800 Main St Fl 3, Bridgeport, CT 06606-4201 2016-08-20
1437568003 Donte Jamal Newsom Nurse Practitioner 1370 Johnson Ave Ste 202, Bridgeport, WV 26330-1378 2014-08-08
1053675033 Joanna R Fernandez Nurse Practitioner 500 Palisade Ave, Bridgeport, CT 06610-3458 2012-06-25
1558678623 Dermatology Outreach, LLC Nurse Practitioner 111 State St., Bridgeport, WV 26330 2010-09-09
1659546109 Christine Margaret Berte Nurse Practitioner 790 Fairfield Ave, Bridgeport, CT 06604-3701 2008-04-25
1043383508 Susan Flanigan Bates Nurse Practitioner Mcmwtc Bldg 3005, Hc 83 Box 1, Bridgeport, CA 93517 2006-11-15
1629048418 Renee Biehl Nurse Practitioner 761 Lindley St, Bridgeport, CT 06606-5043 2006-01-24
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Competitor

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City BRIDGEPORT
Zip Code 06608

Improve Information

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Dataset Information

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.

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