Organization Active NPI

Nova Vita Health Services PC

  • Psychiatry Physician
  • Bridgeport, CT
National Provider Identifier
1023535135
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
50553 Issued in CT
Legal business name
NOVA VITA HEALTH SERVICES PC
Practice address
3180 Main St
Bridgeport, CT 06606
Phone
(203) 870-1616
Fax
(203) 870-1615
NPI assigned
Aug 29, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ubong Jackson Udoyen
Title
MD
Phone
(203) 870-1616

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 50553 CT Primary

Addresses

Primary practice location

3180 Main St
Bridgeport, CT 06606

Mailing address

3180 Main St
Bridgeport, CT 06606-4237
Phone (203) 870-1616

Other identifiers 1

IdentifierTypeStateIssuer
50553OtherCTSTATE LICENSE

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1023535135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064237",
            "telephone_number": "203-870-1616",
            "fax_number": "203-870-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06606",
            "telephone_number": "203-870-1616",
            "fax_number": "203-870-1615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA VITA HEALTH SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "UDOYEN",
        "authorized_official_first_name": "UBONG",
        "authorized_official_middle_name": "JACKSON",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "203-870-1616"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "50553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "50553",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.