Otoole, Michael P

Otoole, Michael P is an individual health care provider with primary practice located at 475 Clinton Ave , Bridgeport CT 06605-1700. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is his primary health care specialty. Otoole, Michael P can be contacted via phone (203) 368-4291.

Contact Information

Primary practice address
475 Clinton Ave Bridgeport CT 06605-1700
Phone: (203) 368-4291
Fax: (203) 368-9167
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 007178 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 007178 Connecticut

Profile Details

NPI number 1235656968
LBN Legal business name Otoole, Michael P
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2017
Last updated Dec 20th, 2022 - about 3 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 1235656968 NPPES
Connecticut MEDICAID 004069985

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