NPI 1215573365
My Personal Driver
Practice location
- Address
- 47 Woodlawn Ave, Bridgeport, CT 06606-2962
- Phone
- (860) 600-3132
Authorised official
- Name
- Tyrone Craddock
- Title
- Owner
- Phone
- (860) 600-3132
Registered specialties
Private Vehicle
Primary
Registry record
- NPI
- 1215573365
- Entity type
- Organization
- NPI issued
- 25 Nov 2019
- Record last updated
- 25 Nov 2019
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.