Active NPI
Hill Top I.V. Infusion/ Ketamine and Wellness
- Addiction Medicine (Internal Medicine) Physician
- Bridgeport, CT
National Provider Identifier
1871359984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Medicine (Internal Medicine) Physician
- Legal business name
- HILL TOP I.V. INFUSION/ KETAMINE AND WELLNESS
- Practice address
- 4675 Main St
Bridgeport, CT 06606-1813 - Phone
- (203) 346-1904
- Fax
- (203) 374-7515
- NPI assigned
- Feb 26, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Christina Mojisola Kolade, DO
- Title
- Ceo
- Phone
- (203) 803-8599
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Internal Medicine) Physician | 207RA0401X | Primary |
Addresses
Primary practice location
4675 Main St
Bridgeport, CT 06606-1813
Mailing address
4675 Main St
Bridgeport, CT 06606-1813
Phone (203) 346-1904
Other names 1
- Hill Top I.V. infusion/Ketamine and Wellness
National Provider Directory
National Provider DirectoryLocations
4675 Main St
Bridgeport, CT 06606
Phone (203) 374-6103
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1708905600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1708905600000",
"number": "1871359984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4675 MAIN ST",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066061813",
"telephone_number": "203-346-1904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4675 MAIN ST",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066061813",
"telephone_number": "203-346-1904",
"fax_number": "203-374-7515"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HILL TOP I.V. INFUSION/ KETAMINE AND WELLNESS",
"organizational_subpart": "NO",
"enumeration_date": "2024-02-26",
"last_updated": "2024-02-26",
"certification_date": "2024-02-26",
"status": "A",
"authorized_official_last_name": "KOLADE",
"authorized_official_first_name": "CHRISTINA",
"authorized_official_middle_name": "MOJISOLA",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "203-803-8599",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "207RA0401X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Addiction Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Hill Top I.V. infusion/Ketamine and Wellness",
"code": "3",
"type": "Doing Business As"
}
]
}
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 Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.