MR. TYRONE CRADDOCK (NPI# 1205472396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205472396 |
| Entity Type | Individual |
| Full Name | MR. TYRONE CRADDOCK |
| Practice Address |
47 Woodlawn Ave Bridgeport CT 06606-2962 |
| Practice Telephone | 8606003132 |
| Mailing Telephone | 8606003132 |
| Enumeration Date | 2019-11-23 |
| Last Update Date | 2019-11-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 172A00000X | Driver | 347C00000X | FL | Other Service Providers |
| Y | 347C00000X | Private Vehicle | 347C00000X | CT | Transportation Services |
| Street Address |
47 WOODLAWN AVE |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06606-2962 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215573365 | My Personal Driver | Private Vehicle | 47 Woodlawn Ave, Bridgeport, CT 06606-2962 | 2019-11-25 |
| 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 | 347C00000X |
| Grouping | Transportation Services |
| Classification | Private Vehicle |
| An individual paid to provide non-emergency transportation using their privately owned/leased vehicle. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093321044 | Linda L Link | Private Vehicle | 53205 Poplar Drive, Stobbs Estates, Bridgeport, OH 43912 | 2020-09-16 |
| 1215573365 | My Personal Driver | Private Vehicle | 47 Woodlawn Ave, Bridgeport, CT 06606-2962 | 2019-11-25 |
| 1801048855 | Lawrence Community Healthcare | Private Vehicle | 900 Corporation Line St, Bridgeport, IL 62417-2206 | 2008-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376037747 | Tami C Stuckey | Private Vehicle | 148 Lakeside Ave, Middletown, CT 06457-4161 | 2018-06-19 |
| 1396244398 | Connecticut Branches | Private Vehicle | 30 Hazel Ter Ste 2, Woodbridge, CT 06525-2240 | 2018-02-05 |
| 1235492661 | First Foot Forward Family Solutions LLC | Private Vehicle | 9 Sanford St, West Haven, CT 06516-2351 | 2012-06-20 |
| 1861634073 | B-healthy LLC | Private Vehicle | 31 Tobey Rd Ofc 2, Bloomfield, CT 06002-3521 | 2009-04-02 |
| 1376686402 | Cook's Home Health Center, Inc | Private Vehicle | 81 Hillside Ave, Plymouth, CT 06782-2305 | 2007-02-15 |
| City | BRIDGEPORT |
| Zip Code | 06606 |
Please comment or provide details below to improve the information on MR. TYRONE CRADDOCK.
| 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.