DR. MARIA MIKOLAENKO (NPI# 1063824761) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063824761 |
Entity Type | Individual |
Full Name | DR. MARIA MIKOLAENKO |
Credential | DO |
Practice Address |
2979 Main St Bridgeport CT 06606-4284 |
Mailing Address |
1290 Silas Deane Hwy Wethersfield CT 06109-4337 |
Practice Telephone | 2033822345 |
Practice Fax Number | 2033660868 |
Enumeration Date | 2014-05-29 |
Last Update Date | 2020-10-02 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
66720 | CT | Allopathic & Osteopathic Physicians |
N | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
OS15147 | FL | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | STATE LICENSE | OS15147 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
16 Station Rd Ste 5, Bellport, NY 117132449 | 6312863995 | |
1545 9th St Sw, Vero Beach, FL 329624312 | 7722578224 | 7722133157 |
787 37th St Ste 140, Vero Beach, FL 32960 | 7722578224 | 7722133157 |
Street Address |
2979 MAIN ST |
City | BRIDGEPORT |
State | CT |
Zip Code | 06606-4284 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598761512 | Joseph A Rose | Internal Medicine | 2979 Main St, Bridgeport, CT 06606-4252 | 2005-06-23 |
1639787013 | Alexa Miller | Nurse Practitioner | 2979 Main St, Bridgeport, CT 06606-4284 | 2020-07-21 |
1508487034 | Daniel Kaplan | Physician Assistant | 2979 Main St, Bridgeport, CT 06606-4284 | 2020-05-06 |
1982187175 | Kelly Anne Caulfield | Physician Assistant | 2979 Main St, Bridgeport, CT 06606-4284 | 2018-09-13 |
1043791478 | Danielle C Rivera | Nurse Practitioner | 2979 Main St, Bridgeport, CT 06606-4284 | 2018-08-23 |
1235647181 | Stephanie Larose | Nurse Practitioner | 2979 Main St, Bridgeport, CT 06606-4284 | 2018-01-12 |
1043761042 | Kylie Gargano | Nurse Practitioner | 2979 Main St, Bridgeport, CT 06606-4284 | 2016-10-14 |
1326495474 | Janelle Duah | Internal Medicine | 2979 Main St, Bridgeport, CT 06606-4284 | 2016-05-18 |
1891082079 | Linette Yadira Rosario Tejeda | Family Medicine | 2979 Main St, Bridgeport, CT 06606-4284 | 2011-07-07 |
1699909432 | Anja Wagner | Internal Medicine | 2979 Main St, Bridgeport, CT 06606-4284 | 2009-05-07 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962023408 | Madeline Acquilano | Pharmacist | 2800 East Main St, Bridgeport, CT 06606 | 2020-05-06 |
1578192001 | Karin Alexandra Skalina | Student in an Organized Health Care Education/Training Program | 2800 Main St., Dept. of Medicine, Bridgeport, CT 06606 | 2020-04-06 |
1720641293 | Valeriia Klymenko | Student in an Organized Health Care Education/Training Program | 2800 Main Street, Department of Medicine, Bridgeport, CT 06606 | 2019-04-19 |
1821579996 | Ashley Liese | Nurse Practitioner | Cardiology Physicians of Fairfield County, 2679 Main St, Bridgeport, CT 06606 | 2018-08-27 |
1699261289 | Gema Estefania Giler-sacoto | Student in an Organized Health Care Education/Training Program | St. Vincent's Medical Center, 2800 Main Street, Department of Medicine, Bridgeport, CT 06606 | 2018-07-06 |
1114418365 | Jona Bumci | Physician Assistant | 3180 Main St Ste 304, Bridgeport, CT 06606 | 2018-05-23 |
1023471299 | Qmg4, LLC | Family Medicine | 4200 Main Street, Bridgeport, CT 06606 | 2016-04-04 |
1861867442 | Marie Dorothea Lisieski | Social Worker | 2400 Main Street, Bridgeport, CT 06606 | 2015-12-08 |
1548603384 | Gerald E. Hedley | Internal Medicine | 390 Charles Street Unit #101, Bridgeport, CT 06606 | 2013-04-11 |
1487997581 | Gerald Micalizzi, M.d., LLC | Radiology | 558 Fairview Avenue, Bridgeport, CT 06606 | 2013-03-27 |
Find all providers in zip 06606 |
Taxonomy Code | 207QA0505X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Specialization | Adult Medicine |
Definition to come. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477068773 | Emily T Carter | Family Medicine | 968 Fairfield Ave, Bridgeport, CT 06605-1116 | 2017-12-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871067447 | Christina Marie Bolduc Falzone | Family Medicine | 35 Talcottville Rd Ste 1, Vernon, CT 06066-5261 | 2019-01-17 |
1760724165 | John Ordway Alden | Family Medicine | 20 Loeffler Rd, T521c, Bloomfield, CT 06002-2276 | 2013-03-23 |
1598098881 | Anita Boyd Bennett | Family Medicine | 1249 Boulevard, West Hartford, CT 06119-1603 | 2009-09-17 |
1740329168 | Seymour Isaac Kummer | Family Medicine | 67 N Park St, Ellington, CT 06029-4135 | 2007-02-05 |
1225101991 | Syed Hyder Reza | Family Medicine | 345 Main Ave, Pmcc, Norwalk, CT 06851-1547 | 2006-11-17 |
1356433486 | Windsor Locks Medical Center, LLP | Family Medicine | 73 Old County Road, Windsor Locks, CT 06096 | 2006-09-28 |
1609982834 | Angelika Jovin | Family Medicine | 27 Commerce St, Clinton, CT 06413-2054 | 2006-08-21 |
1720014798 | James M. Perlotto | Family Medicine | 55 Lock St., New Haven, CT 06520-8237 | 2006-06-23 |
1184666430 | Alicja Jadwiga Harbut IIi | Family Medicine | 25 Clinton St, New Britain, CT 06053-3509 | 2006-06-12 |
1740265925 | Yogesh Kumar Katechia | Family Medicine | 2 Lathrop Ave, Norwich, CT 06360-2309 | 2005-12-11 |
Find all providers with the same taxonomy |
City | BRIDGEPORT |
Zip Code | 06606 |
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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.