MATTIA BROSE (NPI# 1104365071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104365071 |
| Entity Type | Individual |
| Full Name | MATTIA BROSE |
| Credential | APRN |
| Practice Address |
421 Cottage Grove Rd Bloomfield CT 06002-3336 |
| Mailing Address |
421 Cottage Grove Rd Bloomfield CT 06002-3170 |
| Practice Telephone | 8602423990 |
| Mailing Telephone | 8602423990 |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2017-04-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
6947 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
6947 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
421 COTTAGE GROVE RD |
| City | BLOOMFIELD |
| State | CT |
| Zip Code | 06002-3336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245226406 | Eric Robin Goldberg | Family Medicine | 421 Cottage Grove Rd, Suite B, Bloomfield, CT 06002-3119 | 2005-09-23 |
| 1902254725 | Natalie M Cooper | Nurse Practitioner | 421 Cottage Grove Rd, Bloomfield, CT 06002-3170 | 2016-06-02 |
| 1275971905 | Christine Marie Hanna | Family Medicine | 421 Cottage Grove Rd, Bloomfield, CT 06002-3170 | 2013-06-04 |
| 1841526068 | The Urgent Care Center of Connecticut, LLC | Family Medicine | 421 Cottage Grove Rd, Suite B, Bloomfield, CT 06002-3119 | 2009-10-22 |
| 1013133628 | Richard Siahaan | Internal Medicine | 421 Cottage Grove Rd, Bloomfield, CT 06002-3170 | 2007-04-18 |
| 1518981448 | Gilberto Ramirez | Family Medicine | 421 Cottage Grove Rd, Suite A, Bloomfield, CT 06002-3119 | 2006-07-26 |
| 1740235282 | Donald Maxwell | Internal Medicine | 421 Cottage Grove Rd, Suite B, Bloomfield, CT 06002-3119 | 2006-05-23 |
| 1164493243 | Jill T Nelson | Nurse Practitioner | 421 Cottage Grove Rd, Suite A, Bloomfield, CT 06002-3119 | 2006-01-27 |
| 1578554499 | Robert Allen Green | Orthopaedic Surgery | 421 Cottage Grove Rd, Suite A, Bloomfield, CT 06002-3170 | 2005-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558908897 | Duncaster, Inc. | Clinic/Center | 30 Loeffler Rd., Bloomfield, CT 06002 | 2019-12-05 |
| 1104467919 | Caroline Suzanne Carey Oesch | Counselor | 71 West Dudley St, Bloomfield, CT 06002 | 2019-10-02 |
| 1679047534 | Inspire Me, LLC | Counselor | 1-2 Camelot Drive, Bloomfield, CT 06002 | 2019-01-14 |
| 1508348947 | Rebecca Perry | Student in an Organized Health Care Education/Training Program | 693 Bloomfield Avenue, Bloomfield, CT 06002 | 2018-09-01 |
| 1760996946 | Monique Edwards | Social Worker | 705 New Briatin Ave, Chd, Bloomfield, CT 06002 | 2017-11-27 |
| 1225564412 | Merva E Dixon | Nurse Practitioner | 38 Hill Farm Rd, Bloomfield, CT 06002 | 2017-05-07 |
| 1538602610 | Jaime Acevedo | Counselor | 571 Bloomfield Ave, Bloomfield, CT 06002 | 2016-11-22 |
| 1669835138 | Jacob Badura | Pharmacist | 799-824 Park Ave, Bloomfield, CT 06002 | 2016-04-01 |
| 1316283328 | Julie Jason Farrelly | Counselor | 45 Wintonbury Ave Ste 102, Bloomfield, CT 06002 | 2012-12-19 |
| 1184915860 | Rachel Benedetto Scott | Surgery | 6 Northwestern Drive, Suite 305, Bloomfield, CT 06002 | 2011-04-28 |
| Find all providers in zip 06002 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760009609 | Kesone T Telfer | Nurse Practitioner | 36 Walsh St, Bloomfield, CT 06002-3261 | 2020-06-26 |
| 1346721768 | Juliana Lima | Nurse Practitioner | 194 Broad St Ste 4, Bloomfield, NJ 07003-2606 | 2018-08-23 |
| 1154841468 | Nhat Minh Nguyen | Nurse Practitioner | 3 Donald St, Apt. D, Bloomfield, NJ 07003 | 2017-06-27 |
| 1679009716 | Raxine Avis Christie-campbell | Nurse Practitioner | 24 Foothills Way, Bloomfield, CT 06002-1640 | 2017-05-11 |
| 1740727791 | Benjamin Quidangen | Nurse Practitioner | 12 Lewis St, Bloomfield, NJ 07003-6017 | 2017-01-30 |
| 1821541855 | Gretchen A. Myers | Nurse Practitioner | 8047 Pierpont Rd, Bloomfield, NY 14469-9714 | 2016-07-26 |
| 1003091497 | Bloomfield Medical Clinic, PC | Nurse Practitioner | 105 S Broadway Avenue, Bloomfield, NE 68718-0357 | 2008-01-03 |
| 1497786354 | James B Guynn | Nurse Practitioner | 100 N Church St Ste C, Bloomfield, NM 87413-5754 | 2006-07-06 |
| 1881622900 | Jody Lynn Root | Nurse Practitioner | 10858 E State Road 54, Suite #1, Bloomfield, IN 47424-6069 | 2006-06-29 |
| 1386692077 | Sunny Lynn Nagengast | Nurse Practitioner | 105 S Broadway, Bloomfield, NE 68718-0357 | 2006-05-04 |
| Find all providers in BLOOMFIELD | ||||
| City | BLOOMFIELD |
| Zip Code | 06002 |
Please comment or provide details below to improve the information on MATTIA BROSE.
| 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.