Individual
MONIKA MISHRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1302 S MAIN ST, WATERBURY, CT 06706-1748
(203) 756-8021
Mailing address
2800 MAIN ST, BRIDGEPORT, CT 06606-4201
(203) 576-5576
(203) 576-5022
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
57006
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008081148
—
CT
01
—
1316333990
CONNECTICARE
CT
01
—
223160873
UNITED HEALTH CARE
CT
01
—
6862292
CIGNA
CT
01
—
D400489070
MEDICARE
CT
Enumeration date
04/10/2015
Last updated
09/19/2019
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