| Anthony Mongillo, MD | |
|
3180 Main St, Suite 301, Bridgeport, CT 06606-4237 | |
| (203) 373-9100 | |
| (203) 365-8492 |
| Full Name | Anthony Mongillo |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Location | 3180 Main St, Bridgeport, Connecticut |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558324228 | NPI | - | NPPES |
| 001238252 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 023825 (Connecticut) | Primary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | 023825 (Connecticut) | Secondary |
| Entity Name | Northeast Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043278351 PECOS PAC ID: 1254233836 Enrollment ID: O20040123000522 |
| Mailing Address | Practice Location Address |
|---|---|
| Anthony Mongillo, MD 3180 Main St, Suite 301, Bridgeport, CT 06606-4237 Ph: (203) 373-9100 | Anthony Mongillo, MD 3180 Main St, Suite 301, Bridgeport, CT 06606-4237 Ph: (203) 373-9100 |
Mitchell Andrew Fogel, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 900 Madison Ave, Suite 209, Bridgeport, CT 06606 Phone: 203-335-0195 Fax: 203-335-7293 | |
Christian Heineken, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 3180 Main St, Suite 301, Bridgeport, CT 06606 Phone: 203-373-9100 Fax: 203-365-8492 | |
Pasquale Masone, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 3180 Main St, Suite 301, Bridgeport, CT 06606 Phone: 203-373-9100 Fax: 203-365-8492 | |
Kevin B Panzer, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 1381 Reservoir Ave., Bridgeport, CT 06606 Phone: 203-371-5197 | |
Ms. Lucia Plichtova, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 267 Grant Street, Bridgeport, CT 06610 Phone: 203-384-3792 | |
Hilda Daureen Kyotakoze, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 4920 Main St Fl 2, Bridgeport, CT 06606 Phone: 203-371-2986 | |
Karen A Hutchinson, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 226 Mill Hill Ave, 3rd Floor, Bridgeport, CT 06610 Phone: 203-384-3873 Fax: 203-384-3829 |