Kwame Adjei-Sefah
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Bridgeport, CT
NPI 1306648589 · NPPES record last updated Mar 26, 2025
Key facts
- NPI
- 1306648589
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 267 Grant St
Bridgeport, CT 06610-2805 - Phone
- (203) 384-3792
- Fax
- (203) 384-4294
- NPI assigned
- Mar 26, 2025
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250627003801 | CT | Order and Referring Only - Internal Medicine |
5799298212 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
267 Grant St
Bridgeport, CT 06610-2805
Mailing address
267 Grant St
Bridgeport, CT 06610-2805
Phone (203) 384-3792
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All providers in Bridgeport, CT · Student in an Organized Health Care Education/Training Program in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 26, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.