KELLY M BUCCI-DIDOMENICO (NPI# 1568795094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568795094 |
| Entity Type | Individual |
| Full Name | KELLY M BUCCI-DIDOMENICO |
| Practice Address |
479 Helen St Bridgeport CT 06608-1321 |
| Mailing Address |
471 Barnum Ave Bridgeport CT 06608-2409 |
| Practice Telephone | 2035798310 |
| Practice Fax Number | 2036833620 |
| Mailing Telephone | 2035763885 |
| Mailing Fax Number | 2036833620 |
| Enumeration Date | 2009-09-16 |
| Last Update Date | 2015-02-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
1809 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004234788 | 05 |
| Street Address |
479 HELEN ST |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06608-1321 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558480673 | City of Bridgeport Health Dept. | Clinic/Center | 479 Helen St, Bridgeport, CT 06608-1321 | 2007-03-28 |
| 1518187087 | Kettelie Paulemon | Social Worker | 479 Helen St, Bridgeport, CT 06608-1321 | 2007-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184193591 | Full Circle Youth Empowerment | Community/Behavioral Health | 583-585 East Main Street, Bridgeport, CT 06608 | 2018-11-14 |
| 1225548332 | Vicarah, LLC | Home Health | 941 East Main Street, Bridgeport, CT 06608 | 2017-10-03 |
| 1285092346 | Heavenly Providers, LLC | Home Health | 1071 William St, Bridgeport, CT 06608 | 2016-02-04 |
| 1659590131 | Annette Tirado | Social Worker | 982 East Main St, Bridgeport, CT 06608 | 2007-04-24 |
| 1629023536 | Brenda I Kulikowski | Midwife | 982 East Main Street, Optimus Health Care, Bridgeport, CT 06608 | 2006-05-23 |
| 1043695588 | Kirithika Mohanathaas | Internal Medicine | 471 Barnum Ave, Bridgeport, CT 06608 | 2015-07-27 |
| 1871749937 | Michele J Feinberg | Psychiatry & Neurology | 982 E Main St, Bridgeport, CT 06608 | 2008-08-08 |
| 1023225646 | Regional Network of Programs, Inc. | Community Based Residential Treatment Facility, Mental Illness | 74 Huntington Rd, Bridgeport, CT 06608-1006 | 2007-05-16 |
| 1295013910 | Lorraine Dionne Brooks-williams | Registered Nurse | 100 Putnam St, Ph, Bridgeport, CT 06608-1045 | 2011-07-29 |
| 1689157471 | Tageldin Banaga | Driver | 1333 E Main St Apt 5, Bridgeport, CT 06608-1400 | 2018-09-08 |
| Find all providers in zip 06608 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861915019 | Stephanie Jean Fluharty | Nurse Practitioner | 1511 Johnson Ave Ste 104, Bridgeport, WV 26330-1016 | 2017-07-19 |
| 1730601006 | Katherine Smith Carter | Nurse Practitioner | 68 Woodland Ave, Bridgeport, CT 06605-3457 | 2017-07-08 |
| 1285186148 | Helen Leahy | Nurse Practitioner | 439 Mill Hill Ave., Bridgeport, CT 06610 | 2016-10-26 |
| 1588119408 | Lisa M Finoia | Nurse Practitioner | 2800 Main St Fl 3, Bridgeport, CT 06606-4201 | 2016-08-20 |
| 1437568003 | Donte Jamal Newsom | Nurse Practitioner | 1370 Johnson Ave Ste 202, Bridgeport, WV 26330-1378 | 2014-08-08 |
| 1053675033 | Joanna R Fernandez | Nurse Practitioner | 500 Palisade Ave, Bridgeport, CT 06610-3458 | 2012-06-25 |
| 1558678623 | Dermatology Outreach, LLC | Nurse Practitioner | 111 State St., Bridgeport, WV 26330 | 2010-09-09 |
| 1659546109 | Christine Margaret Berte | Nurse Practitioner | 790 Fairfield Ave, Bridgeport, CT 06604-3701 | 2008-04-25 |
| 1043383508 | Susan Flanigan Bates | Nurse Practitioner | Mcmwtc Bldg 3005, Hc 83 Box 1, Bridgeport, CA 93517 | 2006-11-15 |
| 1629048418 | Renee Biehl | Nurse Practitioner | 761 Lindley St, Bridgeport, CT 06606-5043 | 2006-01-24 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 06608 |
Please comment or provide details below to improve the information on KELLY M BUCCI-DIDOMENICO.
| 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.