Individual
MICHAEL P OTOOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
475 CLINTON AVE, BRIDGEPORT, CT 06605-1700
(203) 368-4291
(203) 368-9167
Mailing address
475 CLINTON AVE, BRIDGEPORT, CT 06605-1700
(203) 368-4291
(203) 368-9167
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
007178
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
007178
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004069985
—
CT
Enumeration date
08/24/2017
Last updated
12/20/2022
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