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Individual

MICHAEL BECKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BA

Contact information

Practice address
238 JEWETT AVE, BRIDGEPORT, CT 06606-2845
(203) 372-4301
(203) 373-0835
Mailing address
238 JEWETT AVE, BRIDGEPORT, CT 06606-2845
(203) 372-4301
(203) 373-0835

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004040655
CT
Enumeration date
12/15/2008
Last updated
12/15/2008
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