DR. EBENEZER KOLADE (NPI# 1376618611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376618611 |
| Entity Type | Individual |
| Full Name | DR. EBENEZER KOLADE |
| Credential | M.D. |
| Practice Address |
3851 Main St Bridgeport CT 06606-2864 |
| Practice Telephone | 2033723333 |
| Practice Fax Number | 2033747515 |
| Mailing Telephone | 2033723333 |
| Mailing Fax Number | 2033747515 |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
040029 | CT | Allopathic & Osteopathic Physicians |
| Street Address |
3851 MAIN ST |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06606-2864 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255372108 | New Era Rehabilitation Center,inc | Clinic/Center | 3851 Main St, Bridgeport, CT 06606-2864 | 2006-06-10 |
| 1699305318 | Precious Mcneil | Counselor | 3851 Main St, Bridgeport, CT 06606-2864 | 2020-01-22 |
| 1184106064 | Eriberto Santos | Occupational Therapist | 3851 Main St, Bridgeport, CT 06606-2864 | 2018-09-06 |
| 1275608879 | Christina Kolade | Family Medicine | 3851 Main St, Bridgeport, CT 06606-2864 | 2006-11-21 |
| 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 | 207RA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Addiction Medicine |
| An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922215821 | Luke E O'connor | Internal Medicine | 23 Ellington Ave, Po 878 Willimantic Ct 06022, Ellington, CT 06029 | 2007-05-17 |
| 1962797696 | Genevieve Montagu Von Walstrom | Internal Medicine | 17 Wall St, Madison, CT 06443-3122 | 2011-06-10 |
| 1801103858 | Richard N. Goldberg Md, PC | Internal Medicine | 211 New Britain Rd, Suite 206, Kensington, CT 06037 | 2010-09-10 |
| 1891889010 | Bridget Ann Martell | Internal Medicine | 20 York St., Yale University Section of General Internal Medicine, New Haven, CT 06520 | 2006-10-03 |
| 1952318214 | Deepa Camenga | Internal Medicine | 20 York St, New Haven, CT 06510-3220 | 2006-08-01 |
| 1659340651 | Nermina Bukalo | Internal Medicine | 71 Haynes St, Manchester, CT 06040-4131 | 2006-03-14 |
| City | BRIDGEPORT |
| Zip Code | 06606 |
Please comment or provide details below to improve the information on DR. EBENEZER KOLADE.
| 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.