Mikolaenko, Maria

Mikolaenko, Maria is an individual health care provider with primary practice located at 2979 Main St , Bridgeport CT 06606-4284. She recently has only one registered license in Allopathic & Osteopathic Physicians / Adult Medicine, which is considered as her primary health care specialty. Mikolaenko, Maria can be contacted via phone (203) 382-2345.

Contact Information

Primary practice address
2979 Main St Bridgeport CT 06606-4284
Phone: (203) 382-2345
Fax: (203) 366-0868
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adult Medicine 207QA0505X OS15147 Florida
Allopathic & Osteopathic Physicians / Adult Medicine 207QA0505X 66720 Connecticut

Profile Details

NPI number 1063824761
LBN Legal business name Mikolaenko, Maria
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 29th, 2014
Last updated Oct 2nd, 2020 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063824761 NPPES
Florida Other OS15147 STATE LICENSE

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