| Bridgeport Family Health Llc | |
|
1381 Reservoir Avenue Bridgeport CT 06606-2502 | |
| (203) 371-5197 | |
| (203) 371-6118 |
| Full Name | Bridgeport Family Health Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1381 Reservoir Avenue, Bridgeport, Connecticut |
| Authorized Official Name and Position | Dennis J Williams (PHYSICIAN) |
| Authorized Official Contact | 2033715197 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridgeport Family Health Llc 1381 Reservoir Avenue Bridgeport CT 06606-2502 Ph: (203) 371-5197 | Bridgeport Family Health Llc 1381 Reservoir Avenue Bridgeport CT 06606-2502 Ph: (203) 371-5197 |
| NPI Number | 1538207295 |
|---|---|
| Provider Enumeration Date | 02/02/2007 |
| Last Update Date | 01/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538207295 | NPI | - | NPPES |
| 1093715955 | Other | CT | MEDICARE NPI |
| 1538207295 | Other | CT | GROUP NPI |
| 001302257 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 030225 (Connecticut) | Primary |
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