Individual
CHRISTIAN HEINEKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3180 MAIN ST, SUITE 301, BRIDGEPORT, CT 06606-4237
(203) 373-9100
(203) 365-8492
Mailing address
3180 MAIN ST, SUITE 301, BRIDGEPORT, CT 06606-4237
(203) 373-9100
(203) 365-8492
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
024786
CT
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
024786
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001247865
—
CT
Enumeration date
03/20/2006
Last updated
05/31/2013
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