DR. MARY L GARIBALDI (NPI# 1629100086) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629100086 |
| Entity Type | Individual |
| Full Name | DR. MARY L GARIBALDI |
| Other Name | MARY L BRASCH |
| Credential | M.D. |
| Practice Address |
64 Black Rock Ave Bridgeport CT 06605 |
| Mailing Address |
64 Black Rock Ave Bridgeport CT 06605-1200 |
| Practice Telephone | 2035795000 |
| Practice Fax Number | 2035795113 |
| Mailing Telephone | 2035795000 |
| Mailing Fax Number | 2035795113 |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2019-08-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
64005 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004234788 | 05 |
| Street Address |
64 BLACK ROCK AVE |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649269705 | Kris Kotsay | Dentist | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2005-10-20 |
| 1063942555 | Keitra Thompson | Nurse Practitioner | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2017-06-15 |
| 1497283295 | Jenifer Schmitz | Nurse Practitioner | 64 Black Rock Ave, Bridgeport, CT 06605 | 2017-05-24 |
| 1093256091 | Miriam Feinstein | Physician Assistant | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2017-03-10 |
| 1265828818 | Theresa Integral Dy Djama | Podiatrist | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2015-04-10 |
| 1154722403 | Marlene St Juste | Nurse Practitioner | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2014-09-05 |
| 1245647486 | Lissette I Cruz | Physician Assistant | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2014-07-21 |
| 1891123220 | Nicole Callagy | Nurse Practitioner | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2013-10-22 |
| 1063853638 | Aswani Daraboina | Internal Medicine | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2013-07-11 |
| 1932479409 | Optimus Health Care Inc | Clinic/Center | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | 2011-12-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497312276 | Stacy-ann Thompson-grant | Social Worker | 170 Bennet T Street, Bridgeport, CT 06605 | 2019-05-28 |
| 1720502149 | Sheree Amankwah | Counselor | 170 Bennett Street, Bridgeport, CT 06605 | 2017-07-27 |
| 1417477324 | Aracelis Robertson | Case Manager/Care Coordinator | 1646 Fairfield Avenue, 3rd Floor, Bridgeport, CT 06605 | 2017-06-21 |
| 1699158170 | Cortney Davis | Physician Assistant | 3250 Fairfield Ave, Unit 217, Bridgeport, CT 06605 | 2015-07-02 |
| 1083020051 | Douglas Mccoy | Nurse Practitioner | 46 Albion St., Bridgeport, CT 06605 | 2014-07-10 |
| 1932513785 | Hallie Claire Riggs | Social Worker | 1730 State St Ext, Bridgeport, CT 06605 | 2014-06-19 |
| 1831518513 | Yvonne Booy | Counselor | 46 Albion Street, Bridgeport, CT 06605 | 2014-04-10 |
| 1760556955 | Joel W Allen | Obstetrics & Gynecology | 625 Clinton Ave, Bridgeport, CT 06605 | 2006-11-20 |
| 1316046428 | Allen P Schlein | Orthopaedic Surgery | 650 Clinten Avenue, Bridgeport, CT 06605 | 2006-09-22 |
| 1336127984 | Hancock Pharmacy | Pharmacy | 1557 Fairfield Ave, Bridgeport, CT 06605 | 2006-01-04 |
| Find all providers in zip 06605 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669669453 | Karyn Lynette Molinari-fryer | Pediatrics | 139 Conference Center Way, Suite 113, Bridgeport, WV 26330 | 2007-09-26 |
| 1194817460 | Modern Era Pediatric Practice | Pediatrics | 3715 Main St, Suite 403, Bridgeport, CT 06606-3618 | 2006-09-28 |
| 1366555716 | Peter Joseph Mcloughlin | Pediatrics | 762 Lindley St, Bridgeport, CT 06606-5046 | 2006-08-17 |
| 1598788770 | Anselm Chibuike Anyoha | Pediatrics | 3715 Main St, Suite 403, Bridgeport, CT 06606-3618 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780246306 | Pediatric Health Associates of Coneecticut, LLC | Pediatrics | 239 Silas Deane Hwy, Wethersfield, CT 06109-1730 | 2019-07-03 |
| 1073943668 | Pediatric Walk In Care LLC | Pediatrics | 141 B Hazard Avenue, Enfield, CT 06082-5412 | 2013-11-18 |
| 1225319445 | Enfield Pediatric Associates,p.c. | Pediatrics | 155 Hazard Ave Ste 14, Enfield, CT 06082-4586 | 2011-09-01 |
| 1962686824 | Kimberly Ju Kim | Pediatrics | 820 C Prospect Hill Road, Windsor, CT 06095 | 2007-12-27 |
| 1326166125 | Mary A. Simon | Pediatrics | 7 Melrose Dr, Farmington, CT 06032-0893 | 2007-03-27 |
| 1376678516 | Sydney Zane Spiesel | Pediatrics | 8 Lunar Dr, Woodbridge, CT 06525-2352 | 2007-02-21 |
| 1649314279 | Charles Ray Jones | Pediatrics | 111 Park St Ste F, New Haven, CT 06511-5412 | 2007-02-16 |
| 1427110469 | Radhika Malhotra | Pediatrics | 100 Bank St, Suite 307, Seymour, CT 06483-2806 | 2006-12-15 |
| 1386704682 | Andrews Adu Adade | Pediatrics | 18 Hillandale Ave, Stamford, CT 06902-2808 | 2006-12-11 |
| 1982706032 | John Gerald Pitegoff | Pediatrics | 1225 Silver St, Middletown, CT 06457-3920 | 2006-09-01 |
| Find all providers with the same taxonomy | ||||
| City | BRIDGEPORT |
| Zip Code | 06605 |
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| 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.