Family Health and Wellness Center of Bridgeport, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

041401 Issued in CT

Legal business name

FAMILY HEALTH AND WELLNESS CENTER OF BRIDGEPORT, LLC

Practice address

4699 Main St
Suite 201
Bridgeport, CT 06606-1830

Phone

(203) 372-9002

Fax

(203) 372-6747

NPI assigned

Sep 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Ju, MD

Title

Physician

Phone

(203) 372-9002

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1191024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191024000000",
    "number": "1669669073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4699 MAIN ST",
            "address_2": "SUITE 201",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066061830",
            "telephone_number": "203-372-9002",
            "fax_number": "203-372-6747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4699 MAIN ST",
            "address_2": "SUITE 201",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066061830",
            "telephone_number": "203-372-9002",
            "fax_number": "203-372-6747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH AND WELLNESS CENTER OF BRIDGEPORT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-29",
        "last_updated": "2007-09-29",
        "status": "A",
        "authorized_official_last_name": "JU",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "203-372-9002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CT",
            "license": "041401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olufunmilayo Olubukola Falade, MD
• Glorimar Aillyn Falcon
• Family Dental Group C.a.
• Family Dentistry of Bridgeport P.C.
• Family Foot & Ankle Specialists LLC
• Family Loving Gentle Care Home Care LLC
• Deborah X Fang, MD
• Juan G Farfan, CRNA
• Mariam Farhan
• Anna Victoria Faria, APRN

• Primary Care Clinic/Center in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Primary Care Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.