DR. MARY ANTONETTE EVANGELISTA CORDON


Address: 267 Grant St, Bridgeport, CT 06610-2870
Phone: 2033843000

DR. MARY ANTONETTE EVANGELISTA CORDON (NPI# 1407461890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1407461890
Entity Type Individual
Full Name DR. MARY ANTONETTE EVANGELISTA CORDON
Other Name DR. MARY ANTONETTE CORDON
Credential PHARMD
Practice Address 267 Grant St
Bridgeport
CT 06610-2870
Mailing Address 380 Mather St Apt 6414
Hamden
CT 06514-3199
Practice Telephone 2033843000
Mailing Telephone 2013658136
Enumeration Date 2020-09-11
Last Update Date 2020-09-11
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 183500000X Pharmacist PTP.0000548 CT Pharmacy Service Providers
N 183500000X Pharmacist 0202217006 VA Pharmacy Service Providers
Y 183500000X Pharmacist 28RI03890300 NJ Pharmacy Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
CT CONNECTICUT BOARD OF PHARMACY PTP.0000548 01
VA VIRGINIA BOARD OF PHARMACY 0202217006 01
NJ NEW JERSEY BOARD OF PHARMACY 28RI03890300 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
55 Park St, New Haven, CT 065115474 2036884242

Office Location

Street Address 267 GRANT ST
City BRIDGEPORT
State CT
Zip Code 06610-2870

Providers in the same location

NPI Name Taxonomy Address Enumeration
1104818376 Anthony Peluso Anesthesiology 267 Grant St, Bridgeport Anesthesia Associates, PC, Bridgeport, CT 06610-2805 2005-08-16
1992306138 Anna Maria Clabby Nurse Practitioner 267 Grant St, Bridgeport, CT 06610-2870 2020-11-04
1336756519 Jane Silva Physical Medicine & Rehabilitation 267 Grant St, Bridgeport, CT 06610-2870 2020-09-30
1467064022 Courtney Alexandra Irving Registered Nurse 267 Grant St, Bridgeport, CT 06610-2805 2020-08-17
1528677416 Britnia St. Pierre Registered Nurse 267 Grant St, Bridgeport, CT 06610-2870 2020-07-27
1881203040 Adrianna Janelle Sutfin Registered Nurse 267 Grant St, Bridgeport, CT 06610-2805 2020-07-23
1750990081 Allison Jamie Stark Nurse Anesthetist, Certified Registered 267 Grant St, Bridgeport, CT 06610-2805 2020-07-22
1164030565 Alyssa Garza Nurse Practitioner 267 Grant St, Bridgeport, CT 06610-2805 2020-07-21
1730797549 Laura Bienashski Student in an Organized Health Care Education/Training Program 267 Grant St, Bridgeport, CT 06610-2805 2020-07-17
1841817525 Ashley Schultz Nurse Anesthetist, Certified Registered 267 Grant St, Bridgeport, CT 06610-2805 2020-06-29
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1215553698 Juan G Farfan Nurse Anesthetist, Certified Registered 267 Grant Sreet, Bridgeport, CT 06610 2020-06-22
1104446145 Deepak Rajkumar Vangipuram Student in an Organized Health Care Education/Training Program Department of Medicine, Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 2020-04-20
1275152886 Soniya Abraham Student in an Organized Health Care Education/Training Program Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 2020-04-14
1538621834 Yu Mi Kang Student in an Organized Health Care Education/Training Program 267 Grant Street, Yale New Haven Health/bridgeport Hosp, Bridgeport, CT 06610 2019-04-04
1073075024 Ashwin Pramod Deshmukh Student in an Organized Health Care Education/Training Program Yale New Haven Health / Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 2019-04-01
1790246866 Prachi Mangesh Pednekar Student in an Organized Health Care Education/Training Program Yale New Haven Health/bridgeport Hospital, 261 Grant Street Department of Internal Medicine, Bridgeport, CT 06610 2019-03-29
1194247916 Jessica M. Maddern Social Worker 1558 Barnum Avenue, Building C, Bridgeport, CT 06610 2017-07-13
1922532746 Megha Kureti Student in an Organized Health Care Education/Training Program 267 Grant St Fl 3, Bridgeport, CT 06610 2017-04-18
1831623099 Cynthia Joseph Walters Nurse Anesthetist, Certified Registered Bridgeport Hospital-anesthesia Department, 267 Grant Street, Bridgeport, CT 06610 2017-04-14
1285186148 Helen Leahy Nurse Practitioner 439 Mill Hill Ave., Bridgeport, CT 06610 2016-10-26
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Taxonomy Information

Taxonomy Code 183500000X
Grouping Pharmacy Service Providers
Classification Pharmacist

Taxonomy Definition

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1073162780 Lauren Mccarthy Pharmacist 63 Overlook Dr, Bridgeport, WV 26330-1021 2019-09-05
1780163246 Jill K Bebey Pharmacist 564 A Park Ave, Bridgeport, CT 06604 2018-08-07
1407391485 Sangeetha Ravindran Pharmacist 978 East Main Street, Bridgeport, CT 06608-4640 2016-12-29
1659734150 Jignesh Patel Pharmacist 2610 E Main St, Briarwoods Shopping Center, Bridgeport, CT 06610-1422 2016-04-01
1811363971 Victoria Martinez Pharmacist 25 Duane Pl, Bridgeport, CT 06610-1125 2015-08-12
1760875660 Laura Lowther Pharmacist 300 West Main St., Bridgeport, WV 26330-1178 2015-03-17
1912312232 Paige Cloud Pharmacist 50452 Al Hwy 277, Bridgeport, AL 35740 2014-06-25
1528486677 Tonya Jimmie Pharmacist 284 Forest Dr, Bridgeport, WV 26330-9535 2014-04-04
1861741654 Ryan A Bane Pharmacist 56130 National Rd, Bridgeport, OH 43912-1529 2012-09-07
1841580909 Lee Faust Pharmacist 6155 Dixie Hwy, Bridgeport, MI 48722-9618 2011-04-11
Find all providers in BRIDGEPORT

Competitor

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City BRIDGEPORT
Zip Code 06610

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Dataset Information

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.

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