Garibaldi, Mary L
Garibaldi, Mary L is an individual health care provider with primary practice located at 64 Black Rock Ave , Bridgeport CT 06605. She recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as her primary health care specialty. Garibaldi, Mary L can be contacted via phone (203) 579-5000.Contact Information
Primary practice address
64 Black Rock Ave
Bridgeport CT 06605
Phone: (203) 579-5000
Fax: (203) 579-5113
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X | 64005 | Connecticut |
Profile Details
| NPI number | 1629100086 |
|---|---|
| LBN Legal business name | Garibaldi, Mary L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 12th, 2007 |
| Last updated | Aug 5th, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629100086 | NPPES |
| Connecticut | MEDICAID | 004234788 |
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