MIGUEL ANGEL BRAVO JR. (NPI# 1043849326) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043849326 |
| Entity Type | Individual |
| Full Name | MIGUEL ANGEL BRAVO JR. |
| Credential | MD |
| Practice Address |
56 Franklin St Waterbury CT 06706-1253 |
| Practice Telephone | 2037096479 |
| Mailing Telephone | 2037096479 |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2020-04-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | CT | Student, Health Care |
| Street Address |
56 FRANKLIN ST |
| City | WATERBURY |
| State | CT |
| Zip Code | 06706-1253 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114929379 | Scovill Medical Group, PC | Internal Medicine | 56 Franklin St, Waterbury, CT 06706-1221 | 2005-06-01 |
| 1528676459 | Kate Marie Breiner | Physician Assistant | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-07-16 |
| 1417575192 | Muhammad Tasawar Latif | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-07-09 |
| 1013534148 | Syed Mustajab Ahmed | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-07-06 |
| 1558989681 | Brooj Awan | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-07-06 |
| 1699398438 | Michelle Lauren Yeung | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-05-27 |
| 1841810967 | Diana Shapoval | Physician Assistant | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-04-18 |
| 1235768649 | Sean Michael Burgwardt | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-04-07 |
| 1053948430 | Bhavya Vemuri | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-03-25 |
| 1538795455 | Yucel Aydin | Student in an Organized Health Care Education/Training Program | 56 Franklin St, Waterbury, CT 06706-1253 | 2020-03-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245750538 | Sameerah Ibtisam Rehmani | Internal Medicine | St Mary's Hospital, 56 Franklin Street, Waterbury, CT 06706 | 2017-06-27 |
| 1417208448 | Sherry L Gatling | Durable Medical Equipment & Medical Supplies | 394 Mill Street, 2nd Flr N, Waterbury, CT 06706 | 2012-10-01 |
| 1144505538 | Amanda Maria Delcavo | Physician Assistant | 50 Franklin Street, Waterbury, CT 06706 | 2011-10-17 |
| 1508097031 | Lauren K Ayr-volta | Clinical Neuropsychologist | 133 Scovill Street, Suite 211, Waterbury, CT 06706 | 2009-07-31 |
| 1538206800 | John Chardavoyne | Psychiatry & Neurology | Waterbury Outpatient Clinic, 95 Scovill Street, Waterbury, CT 06706 | 2007-01-30 |
| 1922111632 | Thomas Owen Genese | Internal Medicine | 56 Franklin Street, St. Mary's Hospital - Dept of Medicine, Waterbury, CT 06706 | 2006-08-16 |
| 1013942465 | Nancy Lou Kline | Nurse Practitioner | 133 Scovill Street-waterbury Va Community Based Clinic, #203, Waterbury, CT 06706 | 2006-07-12 |
| 1366823783 | Yamini Sachan | Internal Medicine | 56 Franklin Street, Waterbury, CT 06706 | 2015-06-11 |
| 1962881896 | Daniyal Ahmed Ansari | Internal Medicine | 56 Franklin Street, Saint Mary's Hospital, Waterbury, CT 06706 | 2015-05-26 |
| 1164809885 | Vanessa N. Goyes Ruiz | Student in an Organized Health Care Education/Training Program | 56 Franklin Street, Waterbury, CT 06706 | 2015-05-01 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033748975 | Anxhela Kulla | Student in an Organized Health Care Education/Training Program | 93 Cedar Ave, Waterbury, CT 06705-2702 | 2020-04-03 |
| 1902433766 | Zuhal Gokturk | Student in an Organized Health Care Education/Training Program | 56 Franklin St Dept Of, Waterbury, CT 06706-1253 | 2020-03-23 |
| 1952864787 | Sidhant Singh | Student in an Organized Health Care Education/Training Program | Chase Outpatient Center,160 Robbins Street, Waterbury, CT 06708 | 2019-04-09 |
| 1699272625 | Behnoud Baradaran Noveiry | Student in an Organized Health Care Education/Training Program | 56 Franklin St Ste 1, Waterbury, CT 06706-1281 | 2018-04-06 |
| 1548766959 | Caroline Johnssen | Student in an Organized Health Care Education/Training Program | Chase Outpatient Center, 160 Robbins Street, Waterbury, CT 06708 | 2018-04-04 |
| 1770938508 | Andrew Camacho | Student in an Organized Health Care Education/Training Program | 160 Robbins St., Chase Outpatient Center, Waterbury, CT 06708-2613 | 2016-04-29 |
| 1134591605 | Christine Oliver | Student in an Organized Health Care Education/Training Program | 54 South Main Street, Newtown Clinical Services, Waterbury, CT 06710-2169 | 2015-10-23 |
| 1861893026 | Gopi Durlabhji Ukani | Student in an Organized Health Care Education/Training Program | 59 Sharon Rd Apt 6, Waterbury, CT 06705-4032 | 2014-09-08 |
| 1073874202 | Dykea Torres | Student in an Organized Health Care Education/Training Program | 79 Beacon Street, Waterbury, CT 06704-1701 | 2012-06-05 |
| 1750570222 | Camera Aquila Quebec | Student in an Organized Health Care Education/Training Program | 182 Grand St Fl 4, Waterbury, CT 06702-1914 | 2007-10-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.