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Individual

DR. PATRICK PAUL MASTROIANNI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
340 CAPITOL AVE, BRIDGEPORT, CT 06606-5445
(203) 336-3306
(203) 336-5802
Mailing address
340 CAPITOL AVE, BRIDGEPORT, CT 06606-5445
(203) 336-3306
(203) 336-5802

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
023870
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002199
HEALTHNET PROVIDER ID
CT
01
010023870CT05
ANTHEM BC PROVIDER ID
CT
01
0534330
AETNA PROVIDER ID
CT
01
061386448
BERKLEY CARE PROVIDER ID
CT
01
ZS254
OXFORD HEALTH PROV. ID
CT
Enumeration date
07/13/2006
Last updated
04/19/2010
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