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).
| 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 |
| 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 |
| 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 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 55 Park St, New Haven, CT 065115474 | 2036884242 |
| Street Address |
267 GRANT ST |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06610-2870 |
| 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 | ||||
| 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 |
| Find all providers in zip 06610 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| 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] |
| 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 | ||||
| City | BRIDGEPORT |
| Zip Code | 06610 |
Please comment or provide details below to improve the information on DR. MARY ANTONETTE EVANGELISTA CORDON.
| 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.