NPI 1063824761

Maria Mikolaenko, DO

Practitioner Adult Medicine Physician Bridgeport, CT

Practice location

Address: 2979 Main St, Bridgeport, CT 06606-4284
Phone: (203) 382-2345
Fax: (203) 366-0868
Mailing address: 1290 Silas Deane Hwy, Wethersfield, CT 06109-4337

Registered specialties (2)

Adult Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207QA0505X Licence 66720 (CT)

Other Family Medicine providers in Connecticut →

Adult Medicine Physician

Allopathic & Osteopathic Physicians Taxonomy 207QA0505X Licence OS15147 (FL)

Registry record

NPI: 1063824761
Entity type: Individual
Sex (as registered): Female
NPI issued: 29 May 2014
Record last updated: 2 Oct 2020

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.