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Organization

NOVA VITA HEALTH SERVICES PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
UBONG JACKSON UDOYEN (MD)
(203) 870-1616
Entity
Organization

Contact information

Practice address
3180 MAIN ST, BRIDGEPORT, CT 06606
(203) 870-1616
(203) 870-1615
Mailing address
3180 MAIN ST, BRIDGEPORT, CT 06606-4237
(203) 870-1616
(203) 870-1615

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
50553
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
50553
STATE LICENSE
CT
Enumeration date
08/29/2017
Last updated
07/21/2022
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