Philip a Micalizzi, Jr. M.D. PC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

026207 Issued in CT

Legal business name

PHILIP A MICALIZZI, JR. M.D. PC

Practice address

3180 Main St
Ste 302
Bridgeport, CT 06606-4237

Phone

(203) 372-6505

Fax

(203) 372-5622

NPI assigned

Jul 24, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Philip A Micalizzi II, M.D.

Title

Doctor

Phone

(203) 372-6505

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191715200000",
    "number": "1437359759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 MAIN STREET",
            "address_2": "STE 302",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06606",
            "telephone_number": "203-372-6505",
            "fax_number": "203-372-5622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 MAIN ST",
            "address_2": "STE 302",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064237",
            "telephone_number": "203-372-6505",
            "fax_number": "203-372-5622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP A MICALIZZI, JR. M.D. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-24",
        "last_updated": "2007-10-07",
        "status": "A",
        "authorized_official_last_name": "MICALIZZI",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "203-372-6505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CT",
            "license": "026207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marla Jean Peterson, CRNA
• Jillian Taylor Petrillo, DNP, APRN, CRNA
• Karen Marie Petrok, APRN
• Lorina Pettway
• Phenomenal Woman Counseling LLC
• Jisha Philip, M.D
• Jyothy Philipose, APRN
• Nicole J. Phillips, DNP
• Taylor Phillips, PA-C
• Phoenix Recovery, LLC

• Preferred Provider Organization in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Preferred Provider Organization in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2007; 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.