MARY T PRONOVOST (NPI# 1851350011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851350011 |
| Entity Type | Individual |
| Full Name | MARY T PRONOVOST |
| Credential | M.D. |
| Practice Address |
226 Mill Hill Ave 3rd Floor Bridgeport CT 06610-2811 |
| Mailing Address |
5520 Park Ave Suite 101 Trumbull CT 06611-3463 |
| Practice Telephone | 2033843873 |
| Practice Fax Number | 2033843829 |
| Mailing Telephone | 2032542381 |
| Mailing Fax Number | 2032558515 |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2016-09-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 037703 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 001377036 | 05 |
| Street Address |
226 MILL HILL AVE 3RD FLOOR |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06610-2811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093719700 | Armand John Wolff | Internal Medicine | 226 Mill Hill Ave, 3rd Floor, Bridgeport, CT 06610-2826 | 2005-06-09 |
| 1306443296 | Zachary Edward Cipriano | Speech-Language Pathologist | 226 Mill Hill Ave, Bridgeport, CT 06610-2826 | 2020-10-05 |
| 1417560459 | Susan Carol Carbine | Physical Medicine & Rehabilitation | 226 Mill Hill Ave, Bridgeport, CT 06610-2826 | 2020-08-28 |
| 1013540319 | Erin Rudiak | Nurse Practitioner | 226 Mill Hill Ave, Bridgeport, CT 06610-2826 | 2020-02-15 |
| 1609436088 | Megan Charleston | Physical Therapist | 226 Mill Hill Ave, Bridgeport, CT 06610 | 2019-06-18 |
| 1962066993 | Metehan Imamoglu | Student in an Organized Health Care Education/Training Program | 226 Mill Hill Ave, Bridgeport, CT 06610-2826 | 2019-04-25 |
| 1356905319 | Marisa Beals | Student in an Organized Health Care Education/Training Program | 226 Mill Hill Ave, Bridgeport, CT 06610-2826 | 2019-04-25 |
| 1538722418 | Laura Tafuri | Student in an Organized Health Care Education/Training Program | 226 Mill Hill Ave, Bridgeport, CT 06610-2826 | 2019-04-17 |
| 1396208526 | Omar Tarek Sobh | Student in an Organized Health Care Education/Training Program | 226 Mill Hill Ave, Bridgeport, CT 06610-2826 | 2019-04-14 |
| 1659850196 | Alexandra Theresa Nelson | Speech-Language Pathologist | 226 Mill Hill Ave, Bridgeport, CT 06610-2826 | 2018-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215553698 | Juan G Farfan | Nurse Anesthetist, Certified Registered | 267 Grant Sreet, Bridgeport, CT 06610 | 2020-06-22 |
| 1104446145 | Deepak Rajkumar Vangipuram | Student in an Organized Health Care Education/Training Program | Department of Medicine, Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 | 2020-04-20 |
| 1275152886 | Soniya Abraham | Student in an Organized Health Care Education/Training Program | Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 | 2020-04-14 |
| 1538621834 | Yu Mi Kang | Student in an Organized Health Care Education/Training Program | 267 Grant Street, Yale New Haven Health/bridgeport Hosp, Bridgeport, CT 06610 | 2019-04-04 |
| 1073075024 | Ashwin Pramod Deshmukh | Student in an Organized Health Care Education/Training Program | Yale New Haven Health / Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 | 2019-04-01 |
| 1790246866 | Prachi Mangesh Pednekar | Student in an Organized Health Care Education/Training Program | Yale New Haven Health/bridgeport Hospital, 261 Grant Street Department of Internal Medicine, Bridgeport, CT 06610 | 2019-03-29 |
| 1194247916 | Jessica M. Maddern | Social Worker | 1558 Barnum Avenue, Building C, Bridgeport, CT 06610 | 2017-07-13 |
| 1922532746 | Megha Kureti | Student in an Organized Health Care Education/Training Program | 267 Grant St Fl 3, Bridgeport, CT 06610 | 2017-04-18 |
| 1831623099 | Cynthia Joseph Walters | Nurse Anesthetist, Certified Registered | Bridgeport Hospital-anesthesia Department, 267 Grant Street, Bridgeport, CT 06610 | 2017-04-14 |
| 1285186148 | Helen Leahy | Nurse Practitioner | 439 Mill Hill Ave., Bridgeport, CT 06610 | 2016-10-26 |
| Find all providers in zip 06610 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518319458 | Muhammad Umer Afzaal | Surgery | 267 Grant St Fl St4, Bridgeport, CT 06610-2805 | 2016-07-04 |
| 1316378615 | Artem Dyatlov | Surgery | 2660 Main St Ste 110, Bridgeport, CT 06606-5301 | 2013-12-11 |
| 1952507972 | Sugam B Vasani | Surgery | 527 Medical Park Dr Ste 202, Bridgeport, WV 26330-9009 | 2007-06-26 |
| 1841350964 | Richard J Garvey | Surgery | 310 Mill Hill Ave, Bridgeport, CT 06610-2863 | 2006-12-11 |
| 1528136785 | Subhash O Shah | Surgery | 310 Mill Hill Avenue, Bridgeport, CT 06484 | 2006-12-04 |
| 1134193840 | Adam J Hansen | Surgery | 527 Medical Park Dr Ste 205, Bridgeport, WV 26330-9009 | 2006-02-17 |
| 1780678227 | Stuart Marcus | Surgery | 2800 Main St, St. Vincent's Medical Center, Bridgeport, CT 06606-4201 | 2005-09-09 |
| 1891131595 | Imran Baig | Surgery | 2800 Main St, Bridgeport, CT 06606 | 2013-05-21 |
| 1194089946 | Benjamin A Raymond | Surgery | 527 Medical Park Dr Ste 202, Bridgeport, WV 26330-9009 | 2012-06-26 |
| 1720349905 | United Hospital Center, Inc. | Surgery | 527 Medical Park Dr Ste 202, Bridgeport, WV 26330-9009 | 2012-06-04 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 06610 |
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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.