Organization
BRIDGEPORT ANESTHESIA ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH STONE (AUTHORIZED AGENT)
(203) 384-3072
Entity
Organization
Contact information
Practice address
267 GRANT ST, BRIDGEPORT, CT 06610-2805
(203) 384-3072
Mailing address
7365 MAIN ST, SUITE 310, STRATFORD, CT 06614-1300
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001897
HEALTH NET
CT
05
—
4000170
—
CT
01
—
500HBA011CT01
BCBS CT
CT
01
—
611489800
DEPT OF LABOR
CT
01
—
755634
CONNECTICARE
CT
01
—
A770995
OXFORD HEALTH PLAN
CT
01
—
CD2896
RAILROAD MEDICARE
CT
Enumeration date
07/14/2006
Last updated
10/27/2009
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