FELISHA MACK (NPI# 1851805832) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851805832 |
| Entity Type | Individual |
| Full Name | FELISHA MACK |
| Practice Address |
1635 Central Ave Bridgeport CT 06610-2717 |
| Practice Telephone | 4754399331 |
| Mailing Telephone | 4754399331 |
| Enumeration Date | 2017-11-28 |
| Last Update Date | 2017-11-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
007383 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1635 CENTRAL AVE |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06610-2717 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275592834 | Dianne Duffey | Otolaryngology | 1635 Central Ave, Bridgeport, CT 06610-2717 | 2006-03-22 |
| 1952952418 | Marcia Georges | Social Worker | 1635 Central Ave, Bridgeport, CT 06610-2717 | 2019-09-26 |
| 1528535135 | Steven James Parker | Social Worker | 1635 Central Ave, Bridgeport, CT 06610-2717 | 2018-11-01 |
| 1275060261 | Marian Antinozzi | Social Worker | 1635 Central Ave, Bridgeport, CT 06610-2717 | 2017-05-22 |
| 1992232987 | Shirley Berrios | Social Worker | 1635 Central Ave, Bridgeport, CT 06610-2717 | 2017-05-22 |
| 1225565716 | Lashell Richardson | Social Worker | 1635 Central Ave, Bridgeport, CT 06610-2717 | 2017-05-16 |
| 1639603400 | Laurele Hernandez-arata | Social Worker | 1635 Central Ave, Bridgeport, CT 06610-2717 | 2017-04-18 |
| 1659804714 | Christine Melfi | Social Worker | 1635 Central Ave, Bridgeport, CT 06610-2717 | 2017-04-06 |
| 1902285182 | Crystal Ganat | Social Worker | 1635 Central Ave, Bridgeport, CT 06610-2717 | 2015-05-21 |
| 1780088138 | Regina Mcnamara | Social Worker | 1635 Central Ave, Room 436, Bridgeport, CT 06610-2717 | 2014-10-14 |
| 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 | 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 | 06610 |
Please comment or provide details below to improve the information on FELISHA MACK.
| 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.