| Nova Vita Medical Pc | |
|
3180 Main St Bridgeport CT 06606 | |
| (203) 870-1616 | |
| (203) 870-1615 |
| Full Name | Nova Vita Medical Pc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 3180 Main St, Bridgeport, Connecticut |
| Authorized Official Name and Position | Ubong Jackson Udoyen (MD) |
| Authorized Official Contact | 2038701616 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nova Vita Medical Pc 3180 Main St Bridgeport CT 06606-4237 Ph: (203) 870-1616 | Nova Vita Medical Pc 3180 Main St Bridgeport CT 06606 Ph: (203) 870-1616 |
| NPI Number | 1659884690 |
|---|---|
| Provider Enumeration Date | 11/13/2017 |
| Last Update Date | 06/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659884690 | NPI | - | NPPES |
| 50553 | Other | CT | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 50553 (Connecticut) | Primary |
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