NPI 1043922321

Wellington Provider Group PC

Organisation Family Medicine Physician Bridgeport, CT

Practice location

Address: 1000 Lafayette Blvd STE 1100, Bridgeport, CT 06604-4710
Phone: (859) 518-8817
Fax: (859) 201-1084
Mailing address: 535 Wellington Way STE 330, Lexington, KY 40503-1331

Authorised official

Name: Mariela Bravo
Title: Credentialing Team Lead
Phone: (859) 518-8817

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X

Other Family Medicine providers in Connecticut →

Registry record

NPI: 1043922321
Entity type: Organization
NPI issued: 19 Dec 2022
Record last updated: 19 Dec 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.