Michelle Boccanfuso, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

150990 Issued in CT

Practice address

4200 Park Ave
Bridgeport, CT 06604-1049

Phone

(203) 365-6400

NPI assigned

Oct 15, 2021

Last updated

Oct 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1634256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1205599313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 BIRCHWOOD LN",
            "city": "MONROE",
            "state": "CT",
            "postal_code": "064681025",
            "telephone_number": "203-515-7721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 PARK AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066041049",
            "telephone_number": "203-365-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCCANFUSO",
        "first_name": "MICHELLE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-15",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "150990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Bloch
• Fern Blumenfeld-Jaffe
• Freda Owusua Boateng, M.D.
• Sarpong Boateng, MD, MPH
• Joanna Boback, DNP, APRN,FNP, PMHNP
• David Bogen, CRNA
• Annekie T Bogues
• Razel Emuslan Bolambao, RN
• Rebecca Bolmer, LCSW
• Victoria H Bonner

• Registered Nurse in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Registered Nurse in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; 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.