Marydol Regalado Barbieto

Individual provider Active NPI Registered Nurse · Bridgeport, CT

NPI 1962967513 · NPPES record last updated Feb 7, 2019

Key facts

NPI
1962967513
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
10.064797 (CT)
Practice address
310 Indian Ave
Bridgeport, CT 06606-3903
Phone
(203) 243-8530
NPI assigned
Feb 7, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
10.064797CTMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 10.064797 CT Yes

Addresses

Primary practice location

310 Indian Ave
Bridgeport, CT 06606-3903

Mailing address

310 Indian Ave
Bridgeport, CT 06606-3903
Phone (203) 243-8530

Other providers in Bridgeport, CT

All providers in Bridgeport, CT · Registered Nurse in Connecticut

Sources for this page

Verify at the official NPI Registry.